=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447721865
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROGRESSIVE ORTHOTIC & PROSTHETIC SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2018
-----------------------------------------------------
Last Update Date | 10/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2597 S BROADWAY ST STE A
-----------------------------------------------------
City | PITTSBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66762-6396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-663-7077
-----------------------------------------------------
Fax | 417-621-0058
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9511 E 46TH ST
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74145-7201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-663-7077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEFFREY M ARNETTE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 918-786-7701
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------