OrganizationActive
Creative Orthotic Laboratory
NPI 1306803218 · Prosthetic/Orthotic Supplier · Glendale, AZ
Provider details
- NPI number
- 1306803218
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Mark Gorman, C.e.o.(623) 934-3213
Specialties & taxonomies
Suppliers
Practice location
8608 N 59th Ave
Glendale, AZ 85302-5404
Phone: (623) 934-3213
Fax: (623) 930-1891
Approximate (ZIP-level) locationGet directions
Mailing address
8608 N 59th Ave
Glendale, AZ 85302-5404
Registry dates
- Enumerated
- 2006-04-26
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.