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General NPI Number Information
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NPI Number | 1750610002
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Entity Type | Organization
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Legal Business Name | CENTER FOR ORTHOTIC AND PROSTHETIC CARE OF KY, LLC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 171 N EAGLE CREEK DR SUITE 102
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City | LEXINGTON
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State | KY
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Zip | 40509-1801
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Country | US
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Telephone | 859-264-1817
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Fax | 859-268-5636
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Provider Business Mailing Address
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Address Line | 902 DUPONT RD SUITE 100
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City | LOUISVILLE
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State | KY
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Zip | 40207-4602
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Country | US
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Telephone | 502-899-9247
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Fax | 502-899-9443
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Authorized Official
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Title or Position | COO
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Name | MR. KEITH R SENN
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Credential |
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Telephone | 502-899-9247
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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 | KY
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