MR. Terry J Supan, CPO
NPI #1366461410 in Springfield, Illinois
Provider Information
- NPI Number
- 1366461410
- Entity Type
- Individual
- Name
- MR. Terry J Supan, CPO
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Orthotist
- Credential
- CPO
- Enumeration Date
- Jul 19, 2006
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 355 W CARPENTER STREET
- Address 2
- SUITE B
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62702-4945
- Phone
- (217) 789-1450
Specialties & Taxonomy Codes
| Specialty |
|---|
| Orthotist |
| Prosthetist |
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