# ORA ORTHOPEDICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORA ORTHOPEDICS, PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861035438
- **Legal business name:** ORA ORTHOPEDICS, PC
- **Authorized official:** KENNETH BROCKMAN (CEO)
- **Authorized official phone:** (563) 322-0971

## Contact information

- **Practice address:** 510 VALLEY VIEW DRIVE, MOLINE, IL 61265
- **Practice address phone:** (309) 762-3621
- **Mailing address:** 2300 53RD AVE STE 100, BETTENDORF, IA 52722-7565
- **Mailing address phone:** (563) 322-0971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 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:** 10/25/2019
- **Last updated:** 04/29/2024