Healthcare Provider Details

I. General information

NPI: 1841235785
Provider Name (Legal Business Name): INNOVATIVE PROSTHETICS & ORTHOTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 E 14TH ST STE. 5
HASTINGS NE
68901-3240
US

IV. Provider business mailing address

223 E 14TH ST STE. 5
HASTINGS NE
68901-3240
US

V. Phone/Fax

Practice location:
  • Phone: 402-461-4931
  • Fax:
Mailing address:
  • Phone: 402-461-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ASHVINI SENGAR
Title or Position: OWNER
Credential:
Phone: 402-461-4931