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General NPI Number Information
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NPI Number | 1427731314
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Entity Type | Organization
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Legal Business Name | KICKSTART ORTHOTICS AND PROSTHETICS, PLLC
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 1120 N PINES RD STE C
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-4942
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Country | US
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Telephone | 509-795-1007
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Fax | 509-795-1008
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Provider Business Mailing Address
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Address Line | 1120 N PINES RD STE C
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-4942
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Country | US
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Telephone | 509-795-1007
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Fax | 509-795-1008
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Authorized Official
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Title or Position | MEMBER
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Name | PETER SPRINGS
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Credential | CPO
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Telephone | 509-359-5329
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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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