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General NPI Number Information
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NPI Number | 1285819730
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Entity Type | Organization
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Legal Business Name | GENE E WATTERS PROSTHETICS INC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 722 STATE ST
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City | LEMOYNE
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State | PA
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Zip | 17043-1536
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Country | US
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Telephone | 717-737-7831
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Fax | 717-763-0959
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | LEMOYNE
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State | PA
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Zip | 17043-0066
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Country | US
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Telephone | 717-737-7831
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Fax | 717-763-0959
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRY H RUPP
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Credential | CP
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Telephone | 717-737-7831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PA
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