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Organization
ORA ORTHOPEDICS PC
Active
Organization
ORA ORTHOPEDICS PC
Active
Parent organization
ORA ORTHOPEDICS, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORA ORTHOPEDICS, PC
Authorized official
KENNETH BROCKMAN (CEO)
(563) 322-0971
Entity
Organization
Contact information
Practice address
1225 S OAKWOOD AVE STE 7B, GENESEO, IL 61254-1990
(309) 762-3621
(309) 762-3690
Mailing address
520 VALLEY VIEW DR, MOLINE, IL 61265-6194
(309) 762-3621
(309) 762-3690
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
—
NULL
163WM0705X
Medical-Surgical Registered Nurse
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
060006850
IL
246Z00000X
Other Specialist/Technologist
—
NULL
246Z00000X
Other Specialist/Technologist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/27/2006
Last updated
04/29/2024
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