Provider Demographics
NPI:1003159765
Name:ORTHOSPORT, INC
Entity Type:Organization
Organization Name:ORTHOSPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-782-2070
Mailing Address - Street 1:380 TENNANT AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5478
Mailing Address - Country:US
Mailing Address - Phone:408-782-2070
Mailing Address - Fax:408-782-2071
Practice Address - Street 1:380 TENNANT AVE STE 7
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5478
Practice Address - Country:US
Practice Address - Phone:408-782-2070
Practice Address - Fax:408-782-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies