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General NPI Number Information
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NPI Number | 1255866968
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Entity Type | Organization
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Legal Business Name | NORTH BAY PROSTHETICS AND ORTHOTICS LLC
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/05/2017
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Provider Practice Location Address
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Address Line | 671 ELMIRA RD SUITE 120
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City | VACAVILLE
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State | CA
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Zip | 95687-4655
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Country | US
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Telephone | 707-724-8985
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Fax | 707-724-8986
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Provider Business Mailing Address
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Address Line | 671 ELMIRA RD SUITE 120
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City | VACAVILLE
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State | CA
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Zip | 95687-4655
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Country | US
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Telephone | 707-724-8985
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Fax | 707-724-8986
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL J BRIGHT
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Credential |
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Telephone | 707-724-8985
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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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