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General NPI Number Information
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NPI Number | 1083985014
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Entity Type | Organization
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Legal Business Name | PAUL GARY LAKINS AH-MAZING ORTHOTICS
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 151 SHERWAY RD STE 2
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City | KNOXVILLE
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State | TN
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Zip | 37922-2236
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Country | US
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Telephone | 865-357-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 151 SHERWAY RD STE 2
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City | KNOXVILLE
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State | TN
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Zip | 37922-2236
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Country | US
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Telephone | 865-357-2900
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Fax | 865-357-1210
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Authorized Official
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Title or Position | OWNER
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Name | PAUL GARY LAKINS
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Credential |
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Telephone | 865-684-0533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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