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General NPI Number Information
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NPI Number | 1285632034
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Entity Type | Organization
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Legal Business Name | ORTHOPRO OF CARSON CITY, INC.
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 415 W SOPHIA ST SUITE #200
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City | CARSON CITY
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State | NV
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Zip | 89703-8804
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Country | US
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Telephone | 775-841-0660
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Fax | 775-841-0606
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Provider Business Mailing Address
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Address Line | 415 W SOPHIA ST SUITE #200
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City | CARSON CITY
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State | NV
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Zip | 89703-8804
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Country | US
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Telephone | 775-841-0660
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Fax | 775-841-0606
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODNEY D. MILLER
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Credential | CPO
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Telephone | 775-841-0660
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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 | CPO 01406
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License Number State |
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