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General NPI Number Information
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NPI Number | 1760843650
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Entity Type | Organization
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Legal Business Name | ALLIANCE PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 1241 FRIENDSHIP RD STE 120
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City | BRASELTON
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State | GA
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Zip | 30517-5609
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Country | US
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Telephone | 770-679-3090
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 FRIENDSHIP RD STE 120
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City | BRASELTON
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State | GA
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Zip | 30517-5609
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Country | US
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Telephone | 770-679-3090
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Fax | 770-679-3142
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JASON AUYER
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Credential |
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Telephone | 678-936-2386
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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 | 112
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License Number State | GA
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