Organization
OTTO BOCK ORTHOPEDIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LEWIS (EVP OF LICENSURE)
(512) 806-2756
Entity
Organization
Contact information
Practice address
4022 E BROADWAY RD STE 113, PHOENIX, AZ 85040-8825
(800) 736-8276
Mailing address
PO BOX 734949, DALLAS, TX 75373-4949
(800) 736-8276
(866) 642-2302
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
C001316
AZ
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445525
—
AZ
Enumeration date
01/06/2016
Last updated
03/10/2026
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