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General NPI Number Information
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NPI Number | 1396332847
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Entity Type | Organization
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Legal Business Name | OCONEE PROSTHETICS LLC
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 1050 BARBER CREEK DR STE 103
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City | WATKINSVILLE
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State | GA
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Zip | 30677-4502
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Country | US
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Telephone | 706-850-3883
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1714
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City | WATKINSVILLE
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State | GA
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Zip | 30677-0034
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Country | US
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Telephone | 706-850-3883
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ZACHARY T HUGHES
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Credential | LCP
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Telephone | 706-850-3883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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