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General NPI Number Information
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NPI Number | 1255381471
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Entity Type | Organization
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Legal Business Name | ORTHOCARE SERVICES LLC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 2305 S. I-35 SERVICE ROAD
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City | MOORE
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State | OK
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Zip | 73160-2775
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Country | US
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Telephone | 405-703-1472
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Fax | 405-703-1653
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Provider Business Mailing Address
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Address Line | 2305 S. I-35 SERVICE ROAD
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City | MOORE
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State | OK
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Zip | 73160-2775
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Country | US
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Telephone | 405-703-1472
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Fax | 405-703-1653
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY BIRKS
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Credential | CO L
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Telephone | 405-703-1472
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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 | 26
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License Number State | OK
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