Organization
SUPERIOR PROSTHETICS AND ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY LEE PENFOLD CPO (PRESIDENT)
(906) 231-2212
Entity
Organization
Contact information
Practice address
20075 THIRD STREET, HANCOCK, MI 49930
(906) 523-5896
(906) 523-5897
Mailing address
20075 THIRD STREET, HANCOCK, MI 49930
(906) 523-5896
(906) 523-5897
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO01440
DE
Other
Enumeration date
02/24/2015
Last updated
03/18/2019
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