Provider Demographics
NPI:1457743114
Name:ORANGE ORTHOTICS, LLC
Entity Type:Organization
Organization Name:ORANGE ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-229-5713
Mailing Address - Street 1:611 DRUID RD E
Mailing Address - Street 2:STE 204A
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3959
Mailing Address - Country:US
Mailing Address - Phone:248-229-5713
Mailing Address - Fax:
Practice Address - Street 1:611 DRUID RD E
Practice Address - Street 2:STE 204A
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3959
Practice Address - Country:US
Practice Address - Phone:248-229-5713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier