Organization
KEYSTONE PROSTHETICS AND ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GEORGE PATRICK PT., CPO (PRESIDENT/OWNER)
(570) 587-4110
Entity
Organization
Contact information
Practice address
231 NORTHERN BLVD, STE D, CLARKS SUMMIT, PA 18411-9189
(570) 587-4110
(570) 587-4145
Mailing address
231 NORTHERN BLVD, STE D, CLARKS SUMMIT, PA 18411-9189
(570) 587-4110
(570) 587-4145
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001610040000B
—
PA
Enumeration date
06/22/2005
Last updated
08/22/2020
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