MEDICARE: PRECISION ORTHOTICS AND PROSTHETICS 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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1568040251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION ORTHOTICS AND PROSTHETICS LLC

Provider Business Mailing Address
First Line	:	124 PLEASANT RIDGE DR
Second Line	:
City	:	BELLE CHASSE
State	:	LA
Zip	:	70037-4502
Country	:	US
Telephone Number	:	504-345-1781
Fax Number	:

Provider Business Practice Location Address
First Line	:	9531 JEFFERSON HWY STE A
Second Line	:
City	:	RIVER RIDGE
State	:	LA
Zip	:	70123-2507
Country	:	US
Telephone Number	:	504-345-1781
Fax Number	:

Authorized Official
Title or Position	:	MEMBER/MANAGER
Name	:	RICHARD M DARLING
Credential	:	CP
Telephone Number	:	504-345-1781

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	08/04/2021

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