Healthcare Provider Details

I. General information

NPI: 1811167190
Provider Name (Legal Business Name): PROSTHETIC & ORTHOTIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 MOREHEAD PLZ
MOREHEAD KY
40351-1591
US

IV. Provider business mailing address

455 S WASHINGTON ST SUITE 11
GETTYSBURG PA
17325-2516
US

V. Phone/Fax

Practice location:
  • Phone: 606-783-0103
  • Fax: 606-784-2152
Mailing address:
  • Phone: 717-337-2273
  • Fax: 717-337-2285

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. CHARLES C MCKINLEY
Title or Position: CEO
Credential:
Phone: 859-260-8576