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General NPI Number Information
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NPI Number | 1902801244
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Entity Type | Organization
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Legal Business Name | LEVEL FOUR ORTHOTICS & PROSTHETICS, INC.
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 1673 WESTBROOK PLAZA DR STE 230
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3068
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Country | US
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Telephone | 336-765-2425
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Fax | 336-765-8370
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Provider Business Mailing Address
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Address Line | 2534 EMPIRE DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6710
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Country | US
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Telephone | 336-397-2165
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Fax | 336-397-2167
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Authorized Official
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Title or Position | DIRECTOR, CONTRACTING
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Name | JANET WOODALL
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Credential |
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Telephone | 336-397-0993
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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 | NA
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License Number State | NC
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