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General NPI Number Information
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NPI Number | 1992779995
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Entity Type | Organization
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Legal Business Name | MANSFIELD ORTHOTIC AND PROSTHETIC CENTER, INC.
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 240 MARION AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2115
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Country | US
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Telephone | 419-522-4171
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Fax | 419-525-3269
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Provider Business Mailing Address
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Address Line | 240 MARION AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2115
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Country | US
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Telephone | 419-522-4171
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Fax | 419-525-3269
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID JAMES HOY
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Credential | CPO/L FAAOP
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Telephone | 419-522-4171
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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 | LPO.54
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License Number State | OH
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