Provider Demographics
NPI:1750677365
Name:COMFORT PROSTHETICS & ORTHOTICS
Entity Type:Organization
Organization Name:COMFORT PROSTHETICS & ORTHOTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RELMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-468-4600
Mailing Address - Street 1:140 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YALE
Mailing Address - State:MI
Mailing Address - Zip Code:48097-3318
Mailing Address - Country:US
Mailing Address - Phone:810-387-4710
Mailing Address - Fax:810-387-4718
Practice Address - Street 1:140 S MAIN ST
Practice Address - Street 2:
Practice Address - City:YALE
Practice Address - State:MI
Practice Address - Zip Code:48097-3318
Practice Address - Country:US
Practice Address - Phone:810-387-4710
Practice Address - Fax:810-387-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier