Healthcare Provider Details

I. General information

NPI: 1447575113
Provider Name (Legal Business Name): CAROLINA PROSTHETICS AND ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PLAZA CIR SUITE E
CLINTON SC
29325-7557
US

IV. Provider business mailing address

110 LINER DR
GREENWOOD SC
29646-2310
US

V. Phone/Fax

Practice location:
  • Phone: 864-938-0425
  • Fax: 864-938-0427
Mailing address:
  • Phone: 864-942-7001
  • Fax: 864-942-7008

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: TRICIA ANN MCCREA
Title or Position: VP
Credential:
Phone: 864-942-7001