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NPI Code Detail

MEDICARE: SRT PROSTHETICS & ORTHOTICS LLC

MEDICARE: SRT PROSTHETICS & ORTHOTICS 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
1335E00000XProsthetic/Orthotic SupplierIN

General Provider Information

NPI Number : 1295000909
Entity Type Code : Organization
Provider Name (Legal Business Name) : SRT PROSTHETICS & ORTHOTICS LLC
Provider Business Mailing Address
First Line : 408 E WASHINGTON ST
Second Line :
City : BUTLER
State : IN
Zip : 46721-1179
Country : US
Telephone Number : 866-633-3961
Fax Number : 419-633-3981
Provider Business Practice Location Address
First Line : 1900 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-1304
Country : US
Telephone Number : 866-633-3961
Fax Number : 419-633-3981
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : LESLIE SIEBENALER
Credential :
Telephone Number : 866-633-3961
Provider Enumeration Date : 03/13/2012
Last Update Date : 07/22/2024

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Directions to “SRT PROSTHETICS & ORTHOTICS LLC ” Practice Location

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