Healthcare Provider Details
I. General information
NPI: 1912955881
Provider Name (Legal Business Name): VALLEY INSTITUTE OF PROSTHETICS & ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1524 21ST ST STE. B
BAKERSFIELD CA
93301-4002
US
IV. Provider business mailing address
1524 21ST ST STE. B
BAKERSFIELD CA
93301-4002
US
V. Phone/Fax
- Phone: 661-322-1005
- Fax: 661-322-0528
- Phone: 661-322-1005
- Fax: 661-322-0528
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | NOT APPLICABLE |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
BARRY
W
TOWNSEND
Title or Position: PRESIDENT
Credential: C.P.O.
Phone: 661-322-1005