Organization
CENTRAL ORTHOTIC & PROSTHETIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY S VALLEMBOIS CPO (OWNER)
(559) 776-8512
Entity
Organization
Contact information
Practice address
2039 N FINE AVE, FRESNO, CA 93727-1512
(559) 251-5557
Mailing address
2039 N FINE AVE, FRESNO, CA 93727-1512
(559) 251-5557
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
04/10/2024
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