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General NPI Number Information
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NPI Number | 1588730386
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Entity Type | Organization
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Legal Business Name | BECKLEY ORTHOTICS AND PROSTHETICS LLC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 471 NORTH VANCE DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801-0471
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Country | US
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Telephone | 304-254-8285
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Fax | 304-254-8286
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Provider Business Mailing Address
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Address Line | 471 NORTH VANCE DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801-0471
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Country | US
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Telephone | 304-254-8285
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Fax | 304-254-8286
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID EDWARD PAYNE
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Credential | CPO BOCP
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Telephone | 304-254-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State |
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Taxonomy #2
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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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