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General NPI Number Information
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NPI Number | 1770517690
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Entity Type | Organization
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Legal Business Name | BIRKHOLMS ORTHOPEDIC SERVICES INC.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 510 E CHAPEL ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-4520
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Country | US
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Telephone | 805-928-7044
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Fax | 805-928-7006
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Provider Business Mailing Address
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Address Line | 510 E CHAPEL ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-4520
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Country | US
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Telephone | 805-928-7044
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Fax | 805-928-7006
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Authorized Official
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Title or Position | ORTHOTIST/PROSTHETIST
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Name | MR. HANS JUNKER BIRKHOLM
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Credential | C.P.O., C.PED
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Telephone | 805-928-7044
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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 | SYARD156831210001
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License Number State | CA
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