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General NPI Number Information
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NPI Number | 1609994904
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Entity Type | Organization
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Legal Business Name | AIR ORTHOTICS INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 S BROADWAY STE 200E
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City | EDMOND
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State | OK
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Zip | 73034-3772
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Country | US
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Telephone | 405-216-7540
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Fax | 405-216-8310
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Provider Business Mailing Address
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Address Line | 1 S BROADWAY STE 200E
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City | EDMOND
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State | OK
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Zip | 73034-3772
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Country | US
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Telephone | 405-216-7540
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Fax | 405-216-8310
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONALD STEPHEN POTTER
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Credential | CERTIFIED PEDORTHIST
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Telephone | 405-216-7540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 44
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License Number State | OK
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