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1184831349 NPI number — LIFESTYLES ORTHOTICS AND PROSTHETICS

NPI Number: 1184831349
Health Care Provider/Practitioner: LIFESTYLES ORTHOTICS AND PROSTHETICS

Information about “1184831349” NPI (LIFESTYLES ORTHOTICS AND PROSTHETICS) exists in 1184831349 in HTML format HTML  |  1184831349 in plain Text format TXT  |  1184831349 in PDF (Portable Document Format) PDF  |  1184831349 in an XML format XML  formats.

NPI Number : 1184831349 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184831349",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LIFESTYLES ORTHOTICS AND PROSTHETICS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6751 N 72ND ST STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OMAHA",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68122-1746",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-572-2233",
    "MailingAddressFaxNumber": "402-572-2270",
    "FirstLinePracticeLocationAddress": "6940 VAN DORN ST STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LINCOLN",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68506-2858",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-483-5955",
    "PracticeLocationAddressFaxNumber": "402-483-7396",
    "EnumerationDate": "05/17/2007",
    "LastUpdateDate": "08/22/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROOF",
    "AuthorizedOfficialFirstName": "SHIRLEY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "ADM MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "402-393-2354",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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