Organization
TUCSON ORTHOPEDIC LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY CHAN C.O. (PRESIDENT)
(520) 319-0339
Entity
Organization
Contact information
Practice address
3818 E 5TH ST, TUCSON, AZ 85716-5145
(520) 319-0339
(520) 319-7825
Mailing address
PO BOX 43863, TUCSON, AZ 85733-3863
(520) 319-0339
(520) 319-7825
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBSAZ#0278440
BCBS
AZ
Enumeration date
01/05/2006
Last updated
11/24/2010
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