Organization
CREATIVE ORTHOTIC LABS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI LYNN HAZELWOOD (PRESIDENT)
(623) 934-3213
Entity
Organization
Contact information
Practice address
8608 N 59TH AVE, GLENDALE, AZ 85302-5404
(623) 934-3213
(623) 930-1891
Mailing address
8608 N 59TH AVE, GLENDALE, AZ 85302-5404
(623) 934-3213
(623) 930-1891
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
20519930X
AZ
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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