=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215905609
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROGRESSIVE ORTHOTIC & PROSTHETIC SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2006
-----------------------------------------------------
Last Update Date | 10/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1150 N SAINT FRANCIS ST
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-221-7077
-----------------------------------------------------
Fax | 918-786-7708
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9511 E 46TH ST
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74145-7201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-663-7077
-----------------------------------------------------
Fax | 918-663-7075
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JEFFREY M ARNETTE
-----------------------------------------------------
Credential | CPO, LPO
-----------------------------------------------------
Telephone | 918-663-7077
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number | 5
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------