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General NPI Number Information
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NPI Number | 1831157684
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Entity Type | Organization
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Legal Business Name | GILG PROSTHETICS, INC.
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 87 W HOOD DR
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City | PENSACOLA
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State | FL
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Zip | 32534-3019
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Country | US
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Telephone | 850-474-0414
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Fax | 850-474-0409
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Provider Business Mailing Address
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Address Line | 87 W HOOD DR
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City | PENSACOLA
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State | FL
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Zip | 32534-3019
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Country | US
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Telephone | 850-474-0414
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Fax | 850-474-0409
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Authorized Official
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Title or Position | PRESIDENT/CERTIFIED PROSTHETIST
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Name | MR. KEVIN JOHN GILG
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Credential | C.P.
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Telephone | 850-474-0414
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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 | PRO26
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License Number State | FL
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