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General NPI Number Information
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NPI Number | 1265049092
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Entity Type | Organization
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Legal Business Name | WESTERN RESERVE ORTHOTICS PROSTHETICS CENTRE INC
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 243 THREE SPRINGS DR STE 14A
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City | WEIRTON
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State | WV
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Zip | 26062-3885
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Country | US
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Telephone | 330-792-6826
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Fax |
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Provider Business Mailing Address
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Address Line | 6431 MAHONING AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-2039
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Country | US
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Telephone | 330-792-6826
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Fax | 330-792-8493
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Authorized Official
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Title or Position | ADMINISTRATIVE SUPERVISOR
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Name | DEANNA PALOWITZ
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Credential |
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Telephone | 330-792-6826
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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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