MEDICARE: ORTHOPEDIC MOTION, 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	335E00000X	Prosthetic/Orthotic Supplier	NV19931043060	NV

General Provider Information

NPI Number	:	1962706366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPEDIC MOTION, INC.

Provider Business Mailing Address
First Line	:	3233 W CHARLESTON BLVD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1938
Country	:	US
Telephone Number	:	702-697-7070
Fax Number	:	702-697-7077

Provider Business Practice Location Address
First Line	:	3233 W CHARLESTON BLVD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1938
Country	:	US
Telephone Number	:	702-697-7070
Fax Number	:	702-697-7077

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. ADAM STRYKER
Credential	:
Telephone Number	:	702-697-7070

Provider Enumeration Date	:	12/29/2010
Last Update Date	:	11/23/2016

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Directions to “ORTHOPEDIC MOTION, INC. ” Practice Location

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