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General NPI Number Information
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NPI Number | 1447520986
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Entity Type | Organization
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Legal Business Name | ORTHOTECHNIK LLC
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 167 SOUTH AVE SE
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City | MARIETTA
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State | GA
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Zip | 30060-2378
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Country | US
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Telephone | 770-590-8233
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Fax | 404-583-5963
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Provider Business Mailing Address
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Address Line | 167 SOUTH AVE SE
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City | MARIETTA
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State | GA
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Zip | 30060-2378
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Country | US
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Telephone | 770-590-8233
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Fax | 404-583-5963
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS DEVELOPMENT
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Name | MR. BRIAN WALTER MALONEY
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Credential | JD
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Telephone | 770-590-8233
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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 |
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License Number State |
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