Organization
ORTHOTIC & PROSTHETIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN PROCTOR C.P.O./L.P.O. (PRESIDENT/PRACTITIONER)
(330) 723-6679
Entity
Organization
Contact information
Practice address
283 E REAGAN PKWY, MEDINA, OH 44256-1298
(330) 723-6679
(330) 722-7727
Mailing address
283 E REAGAN PKWY, MEDINA, OH 44256-1298
(330) 723-6679
(330) 722-7727
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
LPO202
OH
335E00000X
Prosthetic/Orthotic Supplier
Primary
LPO202
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0297816
—
OH
Enumeration date
08/03/2006
Last updated
04/05/2024
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