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General NPI Number Information
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NPI Number | 1386646537
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOTICS AND PROSTHETICS
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 2530 S MAIDEN LN
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City | JOPLIN
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State | MO
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Zip | 64804-0349
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Country | US
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Telephone | 417-627-0999
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Fax | 417-627-0938
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Provider Business Mailing Address
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Address Line | 2530 S MAIDEN LN
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City | JOPLIN
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State | MO
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Zip | 64804-0349
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Country | US
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Telephone | 417-627-0999
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Fax | 417-627-0938
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Authorized Official
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Title or Position | OWNER PRACTITIONER
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Name | MR. FRANK W IKERD
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Credential | CPO
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Telephone | 417-627-0999
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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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