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General NPI Number Information
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NPI Number | 1366034647
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Entity Type | Organization
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Legal Business Name | INTEGRITY ORTHOTICS AND PROSTHETICS LLC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 221 STATE HIGHWAY 165 STE F
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City | PLACITAS
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State | NM
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Zip | 87043-9514
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Country | US
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Telephone | 505-437-3900
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Fax | 505-437-3906
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Provider Business Mailing Address
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Address Line | 221 STATE HIGHWAY 165 STE F
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City | PLACITAS
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State | NM
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Zip | 87043-9514
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Country | US
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Telephone | 505-437-3900
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Fax | 505-437-3906
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Authorized Official
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Title or Position | OWNER
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Name | JACQUE NEWMAN
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Credential | CO
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Telephone | 505-437-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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Taxonomy #3
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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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