Healthcare Provider Details

I. General information

NPI: 1124404637
Provider Name (Legal Business Name): ORTHOPEDIC APPLIANCE CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 TATE BLVD SE STE 103
HICKORY NC
28602-4030
US

IV. Provider business mailing address

75 VICTORIA RD
ASHEVILLE NC
28801-4419
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-6305
  • Fax:
Mailing address:
  • Phone: 828-254-6305
  • Fax: 828-254-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberCPO00805
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: OWEN AYCOCK
Title or Position: OWNER/SECRETARY/TREASURE
Credential: COP
Phone: 828-254-6305