MEDICARE: PRECISION 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

General Provider Information

NPI Number	:	1982606273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION PROSTHETICS & ORTHOTICS, INC.

Provider Business Mailing Address
First Line	:	11102 LINDBERGH BUSINESS CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7810
Country	:	US
Telephone Number	:	314-843-3339
Fax Number	:	314-843-1119

Provider Business Practice Location Address
First Line	:	11102 LINDBERGH BUSINESS CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7810
Country	:	US
Telephone Number	:	314-843-3339
Fax Number	:	314-843-1119

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	CASSIE MCCORMACK
Credential	:
Telephone Number	:	314-843-3339

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/22/2020

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