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General NPI Number Information
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NPI Number | 1467797191
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Entity Type | Organization
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Legal Business Name | SPECTRUM ORTHOTICS AND PROSTHETICS, INC.
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 887 PLUMAS ST STE A
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City | YUBA CITY
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State | CA
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Zip | 95991-4026
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Country | US
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Telephone | 530-418-8338
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Fax | 530-815-2736
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Provider Business Mailing Address
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Address Line | 3541 E BARNETT RD STE A
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City | MEDFORD
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State | OR
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Zip | 97504-8306
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Country | US
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Telephone | 541-734-2435
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Fax | 541-734-4366
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. FOREST R SEXTON
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Credential | CPO
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Telephone | 541-734-2435
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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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