MEDICARE: ATLANTA PROSTHETICS & ORTHOTICS, 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

General Provider Information

NPI Number	:	1689915837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA PROSTHETICS & ORTHOTICS, INC

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	404-618-0451
Fax Number	:	404-636-8884

Provider Business Practice Location Address
First Line	:	2061 PEACHTREE RD NE
Second Line	:	SUITE 250
City	:	ATLANTA
State	:	GA
Zip	:	30309-1427
Country	:	US
Telephone Number	:	404-618-0451
Fax Number	:	404-636-8884

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	SHERYL PRICE
Credential	:
Telephone Number	:	503-493-8288

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	12/19/2014

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