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General NPI Number Information
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NPI Number | 1952301640
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Entity Type | Organization
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Legal Business Name | BREAKEY PROSTHETICS, INC.
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 09/30/2012
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Provider Practice Location Address
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Address Line | 820 MALONE RD
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City | SAN JOSE
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State | CA
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Zip | 95125-2639
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Country | US
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Telephone | 408-723-0883
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Fax | 408-723-0890
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Provider Business Mailing Address
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Address Line | 820 MALONE RD
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City | SAN JOSE
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State | CA
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Zip | 95125-2639
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Country | US
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Telephone | 408-723-0883
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Fax | 408-723-0890
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIKE DENNIS GIDDING
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Credential | CP
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Telephone | 408-723-0883
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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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