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General NPI Number Information
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NPI Number | 1063481505
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Entity Type | Organization
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Legal Business Name | ABLE PROSTHETIC CARE, INC.
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2141 EASTVIEW PKWY
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City | CONYERS
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State | GA
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Zip | 30013-5756
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Country | US
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Telephone | 770-922-5540
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Fax | 770-922-8535
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Provider Business Mailing Address
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Address Line | 2141 EASTVIEW PKWY
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City | CONYERS
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State | GA
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Zip | 30013-5756
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Country | US
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Telephone | 770-922-5540
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Fax | 770-922-8535
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Authorized Official
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Title or Position | CFO
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Name | MRS. BRENDA K HOLZER
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Credential |
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Telephone | 770-922-5540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | CP2676
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License Number State | GA
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