Healthcare Provider Details

I. General information

NPI: 1154343887
Provider Name (Legal Business Name): ORTHOPEDIC SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10702A CLEMSON BLVD
SENECA SC
29678-4528
US

IV. Provider business mailing address

10 EDGEWOOD DR
GREENVILLE SC
29605-4236
US

V. Phone/Fax

Practice location:
  • Phone: 864-233-7893
  • Fax: 864-242-3247
Mailing address:
  • Phone: 864-885-0077
  • Fax: 864-885-0084

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: JOEL R VANDERWOOD
Title or Position: PRESIDENT
Credential: CPO
Phone: 864-885-0077