Organization
PEDIATRIC ORTHOTICS AND MOBILITY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MCLAUGHLIN (OWNER)
(480) 788-4199
Entity
Organization
Contact information
Practice address
17505 N 79TH AVE STE 111F, GLENDALE, AZ 85308-8724
(480) 788-4199
Mailing address
17505 N 79TH AVE STE 111F, GLENDALE, AZ 85308-8724
(480) 788-4199
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
222Z00000X
Orthotist
Primary
—
—
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
—
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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