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General NPI Number Information
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NPI Number | 1336456748
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Entity Type | Organization
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Legal Business Name | ATLANTA PROSTHETICS & ORTHOTICS THERAPY DIVISION,LLC
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 59 EXECUTIVE PARK S SUITE 4100
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City | ATLANTA
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State | GA
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Zip | 30329-2208
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Country | US
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Telephone | 404-636-0321
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Fax | 404-636-8884
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Provider Business Mailing Address
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Address Line | 59 EXECUTIVE PARK S SUITE 4100
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City | ATLANTA
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State | GA
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Zip | 30329-2208
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Country | US
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Telephone | 404-636-0321
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Fax | 404-636-8884
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Authorized Official
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Title or Position | PRESIDENT/OWNER/PROSTHETIST
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Name | MR. JAMES HAROLD HUGHES
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Credential | CPO
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Telephone | 404-636-0321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT000130
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License Number State | GA
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