Organization
CUSTOM HEALTHCARE, LLC
Active
Other names
PPS Orthotic & Prosthetic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES C ROGERS (CEO)
(423) 697-0057
Entity
Organization
Contact information
Practice address
1508 N THORNTON AVE, STE 104, DALTON, GA 30720-8516
(706) 529-7651
(706) 529-7680
Mailing address
3700 BRAINERD RD, CHATTANOOGA, TN 37411-3603
(423) 697-0057
(423) 648-9366
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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