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General NPI Number Information
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NPI Number | 1396166351
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Entity Type | Organization
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Legal Business Name | PRECISION PROSTHETICS LLC
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 1403 PLAZA DR
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City | YAZOO CITY
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State | MS
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Zip | 39194-2719
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Country | US
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Telephone | 662-746-8331
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Fax | 662-673-0043
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Provider Business Mailing Address
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Address Line | 5526 SCOTLAND RD
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City | BENTONIA
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State | MS
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Zip | 39040-9310
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Country | US
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Telephone | 601-941-3238
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | TRICIA DUNCAN
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Credential |
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Telephone | 601-878-6945
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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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