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General NPI Number Information
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NPI Number | 1649514845
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Entity Type | Organization
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Legal Business Name | DYNAMICS ORTHOTICS & PROSTHETICS, INC.
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 16077 KAMANA RD SUITE 100
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City | APPLE VALLEY
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State | CA
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Zip | 92307-1331
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Country | US
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Telephone | 760-242-6444
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Fax | 760-242-6446
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Provider Business Mailing Address
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Address Line | 1830 W OLYMPIC BLVD SUITE 123
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City | LOS ANGELES
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State | CA
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Zip | 90006-3734
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Country | US
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Telephone | 213-383-9212
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Fax | 213-383-6421
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Authorized Official
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Title or Position | CERTIFIED PROSTHETIST ORTHOTIST
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Name | MR. PETER J SEAN
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Credential | CPO
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Telephone | 213-383-9212
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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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