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NPI Code Detail

MEDICARE: JUSTIN PFAFF LCPO

MEDICARE:   JUSTIN  PFAFF  LCPO
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
1222Z00000XOrthotist1411TX
2224P00000XProsthetist1411TX

General Provider Information

NPI Number : 1235497231
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN PFAFF LCPO
Provider Business Mailing Address
First Line : 2267 TRAWOOD DR STE C1
Second Line :
City : EL PASO
State : TX
Zip : 79935-3027
Country : US
Telephone Number : 915-599-8883
Fax Number : 915-599-8885
Provider Business Practice Location Address
First Line : 2267 TRAWOOD DR STE C1
Second Line :
City : EL PASO
State : TX
Zip : 79935-3027
Country : US
Telephone Number : 915-599-8883
Fax Number : 915-599-8885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2012
Last Update Date : 04/26/2012

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Directions to “ JUSTIN PFAFF LCPO” Practice Location

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