Healthcare Provider Details

I. General information

NPI: 1114919206
Provider Name (Legal Business Name): SKYLAND PROSTHETICS & ORTHOTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US

IV. Provider business mailing address

3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US

V. Phone/Fax

Practice location:
  • Phone: 828-684-1644
  • Fax: 828-684-0648
Mailing address:
  • Phone: 828-684-1644
  • Fax: 828-684-0648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MELISSA CRONK
Title or Position: OFFICE MANAGER
Credential:
Phone: 828-684-1644