Healthcare Provider Details

I. General information

NPI: 1285351064
Provider Name (Legal Business Name): UNION ORTHOTICS & PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E FRANKLIN ST
MONROE NC
28112-4849
US

IV. Provider business mailing address

104 E FRANKLIN ST
MONROE NC
28112-4849
US

V. Phone/Fax

Practice location:
  • Phone: 704-635-7201
  • Fax:
Mailing address:
  • Phone: 704-635-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTOPHER C HUFFSTETLER
Title or Position: OWNER
Credential: BOCPO
Phone: 704-635-7201