Organization
RIO GRANDE ORTHOTICS AND PROSTHETICS
Active
Other names
ADVANCED PROSTHETICS AND ORTHOTICS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FOREST SEXTON (MEMBER)
(541) 531-0439
Entity
Organization
Contact information
Practice address
1691 GALISTEO ST, SUITE B, SANTA FE, NM 87505-4780
(505) 820-2390
(505) 820-2392
Mailing address
1691 GALISTEO ST, SUITE B, SANTA FE, NM 87505-4780
(505) 820-2390
(505) 820-2392
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
47951
NM
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84927054
—
NM
Enumeration date
11/01/2006
Last updated
10/03/2024
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