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General NPI Number Information
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NPI Number | 1912903105
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Entity Type | Organization
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Legal Business Name | HIGH COUNTRY ORTHOTICS & PROSTHETICS
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 135 S WASHINGTON ST.
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City | CASPER
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State | WY
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Zip | 82601-2738
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Country | US
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Telephone | 307-234-4214
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Fax | 307-237-1228
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Provider Business Mailing Address
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Address Line | 135 S WASHINGTON ST.
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City | CASPER
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State | WY
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Zip | 82601-2738
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Country | US
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Telephone | 307-234-4214
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Fax | 307-237-1228
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Authorized Official
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Title or Position | OWNER
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Name | HENRY ARTHUR OSBORNE
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Credential | CO
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Telephone | 307-234-4214
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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