Healthcare Provider Details

I. General information

NPI: 1073810511
Provider Name (Legal Business Name): BRIAN ALAN WAYMAN CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WALDEN RIDGE DR SUITE 400
ASHEVILLE NC
28803-8586
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 828-252-0331
  • Fax: 828-252-9764
Mailing address:
  • Phone: 717-337-2277
  • Fax: 717-337-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: