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Organization

FAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWARD FAIRCHILD CO (CERTIFIED ORTHOTIST)
(607) 348-0343
Entity
Organization

Contact information

Practice address
477 STATE ST, COLONAIL PLAZA, BINGHAMTON, NY 13901-2341
(607) 348-0343
(607) 348-0347
Mailing address
477 STATE ST, COLONAIL PLAZA, BINGHAMTON, NY 13901-2341
(607) 348-0343
(607) 348-0347

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C0003702
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02408313
NY
Enumeration date
11/16/2007
Last updated
11/16/2007
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