Organization
CAROLINA ORTHOTICS AND PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VICK (COO)
(843) 577-9577
Entity
Organization
Contact information
Practice address
3465 W MONTAGUE AVE STE 101, N CHARLESTON, SC 29418-5938
(843) 577-9577
(843) 577-9574
Mailing address
4975 LACROSS RD STE 314, NORTH CHARLESTON, SC 29406-6531
(843) 577-9577
(843) 718-1438
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
554108
—
SC
Enumeration date
12/13/2005
Last updated
02/23/2022
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