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General NPI Number Information
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NPI Number | 1225651813
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Entity Type | Organization
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Legal Business Name | ONWARD AMPUTEE CARE LLC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 6807 SUMMER AVE
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City | BARTLETT
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State | TN
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Zip | 38134-4742
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Country | US
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Telephone | 901-592-0101
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Fax | 901-592-5946
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Provider Business Mailing Address
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Address Line | 6807 SUMMER AVE
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City | BARTLETT
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State | TN
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Zip | 38134-4742
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Country | US
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Telephone | 901-592-0101
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Fax | 901-592-5946
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SEAMAN
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Credential | CPLP
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Telephone | 229-326-2572
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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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