Organization
PRECISION ORTHOTIC LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN KEVIN CROWDER SR. CO (PRESIDENT)
(559) 441-7282
Entity
Organization
Contact information
Practice address
1057 R ST, FRESNO, CA 93721-1312
(559) 441-7282
(559) 441-7209
Mailing address
1057 R ST, FRESNO, CA 93721-1312
(559) 441-7282
(559) 441-7209
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CO003684
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XA0153181
—
CA
Enumeration date
12/15/2006
Last updated
08/22/2020
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