Evergreen Prosthetics and Orthotics, LLC

NPI #1023503497 in Caldwell, Idaho

Provider Information

NPI Number
1023503497
Entity Type
Organization
Organization Name
Evergreen Prosthetics and Orthotics, LLC
Primary Specialty
Prosthetic/Orthotic Supplier
Enumeration Date
Jun 27, 2018
Last Updated
Oct 30, 2023

Practice Location

Address
1818 S 10TH AVE STE 240
State
Idaho
ZIP Code
83605-4880
Phone
(208) 608-6014

Authorized Official

Name
TIMOTHY L O'NEILL, CPO
Title
OWNER
Phone
(503) 407-5408

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Prosthetic/Orthotic Supplier

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