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General NPI Number Information
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NPI Number | 1245233642
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Entity Type | Organization
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Legal Business Name | WILLIAMSPORT ORTHOPEDIC & PROSTHETIC COMPANY INC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 251 PENN ST STE 1
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-5310
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Country | US
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Telephone | 570-322-5277
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Fax | 570-322-1289
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Provider Business Mailing Address
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Address Line | 251 PENN ST STE 1
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-5310
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Country | US
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Telephone | 570-322-5277
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Fax | 570-322-1289
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHLEEN BORGESS
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Credential | BOC-O
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Telephone | 570-322-5277
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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 | PA
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