MEDICARE: AMPRO ORTHOTICS & PROSTHETICS, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier		NV

General Provider Information

NPI Number	:	1326277666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMPRO ORTHOTICS & PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	6877 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0008
Country	:	US
Telephone Number	:	702-457-3200
Fax Number	:	702-457-0908

Provider Business Practice Location Address
First Line	:	7200 CATHEDRAL ROCK DR STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0430
Country	:	US
Telephone Number	:	702-457-3200
Fax Number	:	702-457-0908

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. KAREN WILKINS-JARVIS
Credential	:
Telephone Number	:	702-457-3200

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	07/21/2022

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