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General NPI Number Information
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NPI Number | 1538967146
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Entity Type | Organization
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Legal Business Name | THE AMP GROUP, INC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 500 GLASS LN STE H
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City | MODESTO
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State | CA
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Zip | 95356-9265
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Country | US
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Telephone | 209-579-5628
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 MCHENRY AVE STE 65B
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City | MODESTO
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State | CA
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Zip | 95350-4333
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Country | US
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Telephone | 209-579-5628
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED SIGNER
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Name | CLIVE GRIMBLEBY
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Credential |
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Telephone | 209-579-5628
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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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