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General NPI Number Information
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NPI Number | 1447344296
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Entity Type | Organization
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Legal Business Name | AVA INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 1113 VANDERCOOK WAY SUITE 120
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City | LONGVIEW
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State | WA
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Zip | 98632-4024
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Country | US
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Telephone | 360-423-0459
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Fax | 360-575-1144
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | LONGVIEW
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State | WA
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Zip | 98632-7568
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Country | US
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Telephone | 360-423-0459
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Fax | 360-575-1144
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VICTORIA MILLER
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Credential |
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Telephone | 360-423-0459
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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 | WA
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