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General NPI Number Information
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NPI Number | 1245536424
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Entity Type | Organization
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Legal Business Name | ADVANCED BIOMECHANICAL SOLUTIONS
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 1513 MONTAGUE AVENUE EXT
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City | GREENWOOD
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State | SC
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Zip | 29649-9030
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Country | US
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Telephone | 864-229-3997
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Fax | 864-388-9419
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Provider Business Mailing Address
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Address Line | 1513 MONTAGUE AVENUE EXT
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City | GREENWOOD
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State | SC
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Zip | 29649-9030
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Country | US
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Telephone | 864-229-3997
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Fax | 864-388-9419
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Authorized Official
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Title or Position | PARTNER
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Name | MR. JEREMY S SPROUSE
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Credential | CPO,BOCOP
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Telephone | 864-229-3997
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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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