Healthcare Provider Details

I. General information

NPI: 1336140011
Provider Name (Legal Business Name): BURTON PROSTHETICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5329 CENTER ST
OMAHA NE
68106-2338
US

IV. Provider business mailing address

5329 CENTER ST
OMAHA NE
68106-2338
US

V. Phone/Fax

Practice location:
  • Phone: 402-384-1334
  • Fax: 402-384-1331
Mailing address:
  • Phone: 402-384-1334
  • Fax: 402-384-1331

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. RUSSELL F. BURTON
Title or Position: CERTIFIED PROSTHETIST/ORTHOTIST
Credential: CPO
Phone: 402-384-1334