Healthcare Provider Details

I. General information

NPI: 1700470812
Provider Name (Legal Business Name): A LEG TO STAND ON PROSTHETICS AND ORTHOTICS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 GRIFFIN AVE STE 1A
EASTMAN GA
31023-9104
US

IV. Provider business mailing address

1111 GRIFFIN AVE STE 1A
EASTMAN GA
31023-9104
US

V. Phone/Fax

Practice location:
  • Phone: 478-559-3097
  • Fax: 478-559-3099
Mailing address:
  • Phone: 478-559-3097
  • Fax: 478-559-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROBERT T CAREY
Title or Position: PRESIDENT
Credential: CP LP
Phone: 478-559-3097