Organization
QUAD CITY PROSTHETIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD GOERTZEN CPO (PRESIDENT)
(309) 676-2276
Entity
Organization
Contact information
Practice address
1222 SHOOTING PARK RD, #104, PERU, IL 61354
(815) 223-1781
(815) 223-1787
Mailing address
741 W MAIN ST, PEORIA, IL 61606-1953
(800) 334-5705
(888) 663-6322
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
07/30/2018
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