Organization
PROGRESSIVE ORTHOTICS LTD
Active
Parent organization
PROGRESSIVE ORTHOTICS LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROGRESSIVE ORTHOTICS LTD
Authorized official
MR. BRUCE S GOODMAN CO BOCP (CEO)
(631) 732-5556
Entity
Organization
Contact information
Practice address
280 MIDDLE COUNTRY RD STE G, SELDEN, NY 11784-2532
(631) 732-5556
(631) 732-0218
Mailing address
280 MIDDLE COUNTRY RD STE G, SELDEN, NY 11784-2532
(631) 732-5556
(631) 732-0218
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00615045
—
NY
Enumeration date
11/02/2006
Last updated
03/12/2008
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