Healthcare Provider Details
I. General information
NPI: 1417277138
Provider Name (Legal Business Name): HI-TECH PROSTHETICS & ORTHOTICS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2010
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1027 MINERAL WELLS AVE SUITE 2B
PARIS TN
38242
US
IV. Provider business mailing address
266 S CLEVELAND ST STE 102
MEMPHIS TN
38104-3520
US
V. Phone/Fax
- Phone: 731-642-9984
- Fax: 731-642-9986
- Phone: 901-590-0354
- Fax: 901-590-4319
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | ORTHOTIST -129 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | PROSTHETIST - 99 |
| License Number State | TN |
VIII. Authorized Official
Name: MR.
RAMESH
DUBEY
Title or Position: PRESIDENT
Credential: CPO
Phone: 731-642-9984