Healthcare Provider Details

I. General information

NPI: 1801028378
Provider Name (Legal Business Name): MICHAEL WESTON HUSKEY BOCPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 EAST WALKER ST.
EAST FLAT ROCK NC
28726
US

IV. Provider business mailing address

107 EAST WALKER ST.
EAST FLAT ROCK NC
28726
US

V. Phone/Fax

Practice location:
  • Phone: 828-595-9371
  • Fax: 828-595-9373
Mailing address:
  • Phone: 828-595-9371
  • Fax: 828-595-9373

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: