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General NPI Number Information
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NPI Number | 1386730554
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Entity Type | Organization
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Legal Business Name | ASHLAND PROSTHETIC & ORTHOTIC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 2816 CARTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-324-5786
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Fax | 606-324-5876
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Provider Business Mailing Address
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Address Line | PO BOX 510
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City | ASHLAND
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State | KY
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Zip | 41105-0510
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Country | US
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Telephone | 606-324-5786
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Fax | 606-324-5876
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Authorized Official
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Title or Position | CEO LICENSED PROSTHETIST/ORTHOTIST
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Name | MR. ERVIN L STEPP
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Credential | LPO
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Telephone | 606-324-5786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | BL200612
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License Number State | KY
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