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Organization

MISSOURI CUSTOM ORTHOTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DON HAVEY (OWNER)
(314) 821-2600
Entity
Organization

Contact information

Practice address
12882 MANCHESTER RD, STE. 204, SAINT LOUIS, MO 63131-1858
(314) 821-2600
(888) 770-2935
Mailing address
12882 MANCHESTER RD, STE. 204, SAINT LOUIS, MO 63131-1858
(314) 821-2600
(888) 770-2935

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
02/14/2013
Last updated
07/10/2013
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