Healthcare Provider Details

I. General information

NPI: 1205894888
Provider Name (Legal Business Name): PROSTHEIC SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1479 PARKER RD SE SUITE 600
CONYERS GA
30094-6636
US

IV. Provider business mailing address

1479 PARKER RD SE SUITE 600
CONYERS GA
30094-6636
US

V. Phone/Fax

Practice location:
  • Phone: 770-483-7060
  • Fax: 770-483-9292
Mailing address:
  • Phone: 770-483-7060
  • Fax: 770-483-9292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0900X
TaxonomyAmputee Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID E HUGGINS
Title or Position: OWNER
Credential: CP
Phone: 770-483-7060