Healthcare Provider Details

I. General information

NPI: 1093711244
Provider Name (Legal Business Name): PEEPLES ORTHOTICS & PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7570 W 21ST ST N STE 1026B
WICHITA KS
67205-1734
US

IV. Provider business mailing address

7570 W 21ST ST N STE 1026B
WICHITA KS
67205-1734
US

V. Phone/Fax

Practice location:
  • Phone: 316-773-5511
  • Fax: 316-773-5587
Mailing address:
  • Phone: 316-773-5511
  • Fax: 316-773-5587

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: MR. STEVE PEEPLES
Title or Position: OWNER
Credential: CO
Phone: 316-773-5511