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General NPI Number Information
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NPI Number | 1104063502
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Entity Type | Organization
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Legal Business Name | ACHILLES PROSTHETICS AND ORTHOTICS, INC
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 842 CALIFORNIA BLVD
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2902
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Country | US
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Telephone | 805-541-3800
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Fax | 805-541-3818
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Provider Business Mailing Address
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Address Line | 842 CALIFORNIA BLVD
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2902
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Country | US
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Telephone | 805-541-3800
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Fax | 805-541-3818
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL J NEWTON
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Credential | B.S., F.A.C., C.P.
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Telephone | 661-323-5944
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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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