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General NPI Number Information
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NPI Number | 1932489945
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Entity Type | Organization
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Legal Business Name | ORTHOPRO SERVICES, LLC
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 711 N JEFFERSON ST STE C
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City | ALBANY
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State | GA
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Zip | 31701-5118
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Country | US
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Telephone | 229-435-1409
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Fax | 229-573-7187
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Provider Business Mailing Address
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Address Line | 2505 MOORE STATION RD
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City | DUBLIN
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State | GA
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Zip | 31021-2964
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Country | US
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Telephone | 478-272-6522
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Fax | 478-272-3992
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. RYAN GATLIN
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Credential | CPO
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Telephone | 478-272-6522
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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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