Organization
ARK VALLEY ORTHOTICS AND PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON TANNER CPO (OWNER)
(316) 630-8420
Entity
Organization
Contact information
Practice address
12911 E 21ST ST N, WICHITA, KS 67230-7408
(316) 630-8420
(316) 630-0410
Mailing address
12911 E 21ST ST N, WICHITA, KS 67230-7408
(316) 630-8420
(316) 630-0410
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/25/2009
Last updated
02/14/2023
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