Custom Prosthetic & Orthotic in Clinton - Prosthetic/orthotic Supplier
Custom Prosthetic & Orthotic - NPI 1710147301
Custom Prosthetic & Orthotic is a Prosthetic/orthotic Supplier in Clinton, Mississippi. Custom Prosthetic & Orthotic practices all healthcare services and medical treatments related to Prosthetic/orthotic Supplier. The NPI Number for Custom Prosthetic & Orthotic is 1710147301. The last update date is 2012-03-15.
Custom Prosthetic & Orthotic's current location address is 801 E Northside Dr, Clinton, Mississippi. You can contact this provider via phone number 6019061024. The mailing address for Custom Prosthetic & Orthotic is 801 E Northside Dr, Clinton, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Custom Prosthetic & Orthotic |
|---|---|
| Address | 801 E Northside Dr, Clinton, Mississippi |
| Phone Number | 6019061024 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER PRES |
|---|---|
| Authorized Official Name | Owens Mae Johnnie |
| Credentials | CHILD CARE |
| Telephone Number | 6019061024 |
NPI Number Detail
| NPI Number | 1710147301 |
|---|---|
| Provider Enumeration Date | 2008-06-17 |
| Last Updated Date | 2012-03-15 |
Provider Mailing Address Detail
| Address | 801 E Northside Dr |
|---|---|
| City | Clinton |
| State | Mississippi (MS) |
| Post Code | 390563663 |
| Phone Number | 6019061024 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Prosthetic/orthotic Supplier |
|---|---|
| Taxonomy | 335E00000X |
|
Definition: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological f |
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What is the Custom Prosthetic & Orthotic's unique identification number?
The Custom Prosthetic & Orthotic has been assigned the NPI (National Provider Identifier) Number 1710147301 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Custom Prosthetic & Orthotic's physical address?
The Custom Prosthetic & Orthotic is physically located at 801 E Northside Dr, in the city of Clinton, MS, with the postal code 390563663.
What is Custom Prosthetic & Orthotic's area of expertise and its corresponding taxonomy classification?
The Custom Prosthetic & Orthotic's field of specialization is Prosthetic/orthotic Supplier, and it falls under the taxonomy code 335E00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Custom Prosthetic & Orthotic receive the assignment of its 1710147301 from the Centers for Medicare & Medicaid Services?
The Custom Prosthetic & Orthotic was issued its 1710147301 by the Centers for Medicare & Medicaid Services on 2008-06-17.
When was the information regarding Custom Prosthetic & Orthotic, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Custom Prosthetic & Orthotic, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2012-03-15.
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