Organization
INNOVATIVE PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WESLEY HAYGOOD CP (OWNER)
(803) 917-5811
Entity
Organization
Contact information
Practice address
121B PROFESSIONAL LN, PAWLEYS ISLAND, SC 29585-7878
(843) 314-3148
(843) 314-0939
Mailing address
121B PROFESSIONAL LN, PAWLEYS ISLAND, SC 29585-7878
(843) 314-3148
(843) 314-0939
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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