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General NPI Number Information
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NPI Number | 1497183966
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Entity Type | Organization
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Legal Business Name | PROSTHETIC CONCEPTS LLC
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 2201 LANGHORNE ROAD SUITE A
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City | LYNCHBURG
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State | VA
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Zip | 24501-1125
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Country | US
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Telephone | 434-528-1000
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Fax | 434-528-1011
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Provider Business Mailing Address
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Address Line | 2201 LANGHORNE ROAD SUITE A
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City | LYNCHBURG
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State | VA
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Zip | 24501-1125
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Country | US
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Telephone | 434-528-1000
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Fax | 434-528-1011
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Authorized Official
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Title or Position | MEMBER
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Name | MR. TERRY D LOVELESS
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Credential | CPO
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Telephone | 434-528-1000
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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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