MEDICARE: SANLO ORTHOPEDICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	332BC3200X	Customized Equipment (DME)	LPO-47	OK

General Provider Information

NPI Number	:	1033354782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANLO ORTHOPEDICS LLC

Provider Business Mailing Address
First Line	:	7035 E. RENO AVE.
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110
Country	:	US
Telephone Number	:	405-610-6171
Fax Number	:	405-610-6173

Provider Business Practice Location Address
First Line	:	7035 E. RENO AVE.
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110
Country	:	US
Telephone Number	:	405-610-6171
Fax Number	:	405-610-6173

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MRS. ENRIQUETA SANTOS
Credential	:
Telephone Number	:	405-610-6171

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	08/26/2009

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Directions to “SANLO ORTHOPEDICS LLC ” Practice Location

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