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General NPI Number Information
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NPI Number | 1508882473
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Entity Type | Organization
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Legal Business Name | FAMILY ORTHOTICS & PROSTHETICS INC.
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 4005 7TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-1305
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Country | US
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Telephone | 308-338-3550
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Fax | 308-338-3551
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Provider Business Mailing Address
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Address Line | 4005 7TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-1305
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Country | US
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Telephone | 308-338-3550
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Fax | 308-338-3551
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Authorized Official
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Title or Position | OWNER
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Name | MR. KENNETH M VYVLECKA SR.
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Credential | CO,BOCPO
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Telephone | 308-338-3550
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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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