Organization
JENCO MEDICAL INCORPORATED DBA SAMOA PROSTHETICS ORTHOTICS COMPANY
Active
Other names
Samoa Prosthetics Orthotics Company
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW BRACKEN CPO (EXECTIVE DIRECTOR/OWNER)
(801) 455-9300
Entity
Organization
Contact information
Practice address
5958 LITANI SQ, NUU'ULI VILLAGE, PAGO PAGO, AS 96799
(684) 699-0362
Mailing address
356 E 600 S, ST GEORGE, UT 84770-3949
(435) 688-9338
(435) 673-3747
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00324
AS
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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