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General NPI Number Information
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NPI Number | 1821257791
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Entity Type | Organization
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Legal Business Name | OPTIMUS PROSTHETICS FOR VETERANS
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 8517 N DIXIE DR STE 300
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City | DAYTON
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State | OH
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Zip | 45414-2498
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Country | US
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Telephone | 937-454-1900
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Fax | 937-454-1909
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Provider Business Mailing Address
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Address Line | 8517 N DIXIE DR STE 300
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City | DAYTON
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State | OH
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Zip | 45414-2498
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Country | US
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Telephone | 937-454-1900
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Fax | 937-454-1909
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Authorized Official
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Title or Position | MEMBER
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Name | SCOTT SCHALL
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Credential |
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Telephone | 937-454-1900
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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 | LPO11
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License Number State | OH
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