Healthcare Provider Details

I. General information

NPI: 1225482763
Provider Name (Legal Business Name): HOWARD ORTHOTICS AND PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6128 US HIGHWAY11
CANTON NY
13617
US

IV. Provider business mailing address

6128 US HIGHWAY 11
CANTON NY
13617
US

V. Phone/Fax

Practice location:
  • Phone: 315-786-8973
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. WENDY PODVIN
Title or Position: VPA/BILLING MANAGER
Credential:
Phone: 315-786-8973