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General NPI Number Information
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NPI Number | 1831514892
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Entity Type | Organization
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Legal Business Name | ONE STEP CLOSER PROSTHETICS & ORTHOTICS LLC
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 263 W MCKINLEY WAY SUITE 101
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City | POLAND
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State | OH
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Zip | 44514-1696
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Country | US
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Telephone | 330-787-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 6718 STURBRIDGE PL
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City | POLAND
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State | OH
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Zip | 44514-2189
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Country | US
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Telephone | 330-757-8023
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PROSTHETIST
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Name | MR. KEVIN E HAWKINS
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Credential | L.C.P.
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Telephone | 330-787-7090
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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 | LP 46
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License Number State | OH
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