GRANITE STATE ORTHOTICS AND PROSTHETICS LLC NPI 1750565479

NPI Information

GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC is a prosthetic orthotic supplier in Concord, NH. The provider is 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. GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC NPI is 1750565479. The provider is registered as an organization entity type.

The provider's business location address is:

280 PLEASANT ST STE 3
CONCORD, NH
ZIP 03301-553
Phone: (603) 228-7159
Fax: (603) 225-4265

The provider's authorized official is Gerard Joseph Fowler .
The authorized official title is Owner/practitioner and has the following contact phone number (603) 228-7159.

The enumeration date for this NPI number is 12/18/2007 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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