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General NPI Number Information
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NPI Number | 1780728550
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Entity Type | Organization
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Legal Business Name | O & P IN MOTION, INC.
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 18913 SHERMAN WAY
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City | RESEDA
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State | CA
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Zip | 91335-2604
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Country | US
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Telephone | 818-881-1785
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Fax | 818-881-7854
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Provider Business Mailing Address
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Address Line | 18913 SHERMAN WAY
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City | RESEDA
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State | CA
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Zip | 91335-2604
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Country | US
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Telephone | 818-881-1785
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Fax | 818-881-7854
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Authorized Official
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Title or Position | PROSTHETIST ORTHOTIST
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Name | MR. PHILLIP P AMBROSET
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Credential | C.P.O
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Telephone | 818-881-1785
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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 | 1643
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License Number State | DE
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