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General NPI Number Information
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NPI Number | 1770884959
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Entity Type | Organization
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Legal Business Name | ADVANCED PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 5602 WATERS AVE
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City | SAVANNAH
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State | GA
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Zip | 31404
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Country | US
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Telephone | 912-629-7374
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Fax | 912-226-7644
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Provider Business Mailing Address
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Address Line | 5602 WATERS AVE
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City | SAVANNAH
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State | GA
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Zip | 31404
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Country | US
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Telephone | 912-629-7374
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Fax | 912-226-7644
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Authorized Official
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Title or Position | MEMBER
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Name | RUSSELL ZITTRAUER
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Credential |
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Telephone | 912-629-7374
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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 | CPO 61
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License Number State | GA
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