Organization Name: | WILLAMETTE ORTHOTICS & PROSTHETICS LLC |
NPI Number: | 1003955865 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD J NELSON (PRESIDENT) |
Mailing Address: | 454 17th St Ne Salem |
State: | OR US |
Postal Code: | 973014223 |
Phone Number: | 5033646006 |
Fax Number: | 5033646006 |
NPI Enumeration Date: | 02/06/2007 |
NPI Last Update Date: | 04/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |