Organization
OTTO BOCK ORTHOPEDIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LEWIS (EVP OF LICENSURE)
(512) 806-2756
Entity
Organization
Contact information
Practice address
10643 KETTERING DR, CHARLOTTE, NC 28226
(800) 736-8276
Mailing address
PO BOX 734949, DALLAS, TX 75373-4949
(800) 736-8276
(866) 642-2302
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
02286
NC
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02286
IN STATE NC HME LICENSURE
NC
01
—
02396
AUSTIN NC HME LICENSURE
NC
05
—
1104206499
—
NC
Enumeration date
06/02/2015
Last updated
10/22/2025
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