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An organization which supplies or vends orthopedic appliances or apparatuses and artificial body parts used to support, align, prevent, or correct deformities or to replace or improve function of body parts.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prosthetic/Orthotic Supplier |
335E00000X | 51 | Medical Supply Company with Orthotist | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI # | 1952767485 |
| LBN Legal business name | EVERGREEN PROSTHETICS AND ORTHOTICS, LLC |
| Authorized official | TIMOTHY O'NEILL - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/13/2016 |
| Last updated | 11/01/2023 - About 3 years ago |
| Identifiers | n/a |
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EVERGREEN PROSTHETICS AND ORTHOTICS, LLC