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Prosthetic Orthotic Specialist Inc
Prosthetic/Orthotic Supplier in Peoria, Illinois
NPI 1851389449

Prosthetic Orthotic Specialist Inc is a Prosthetic/Orthotic Supplier based in Peoria, IL. Prosthetic Orthotic Specialist Inc practices in Peoria, IL. The NPI Number for Prosthetic Orthotic Specialist Inc is 1851389449 and holds a License No. (Illinois).

The current practice location address for Prosthetic Orthotic Specialist Inc is 701 Ne Jefferson Ave, Peoria, IL and can be reached out via phone at 309-688-9549 and via fax at 309-676-0486.

Location: 701 Ne Jefferson Ave, Peoria, IL, 61606-1953
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1851389449
Provider Name
Prosthetic Orthotic Specialist Inc
Credential
Provider Entity Type
Organization
Address
701 Ne Jefferson Ave, Peoria, IL, 61606-1953
Phone Number
309-688-9549
Fax Number
309-676-0486
Provider Enumeration Date
10/09/2005
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
05770602 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
701 Ne Jefferson Ave
City
Peoria
State
Illinois
Zip
61603
Phone Number
309-688-9549
Fax Number
309-676-0486
person
Provider Business Mailing Address Details
Address
701 Ne Jefferson Ave
City
Peoria
State
Illinois
Zip
61603
Phone Number
309-688-9549
Fax Number
309-676-0486
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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