Organization
SCOTT SABOLICH PROSTHETICS & RESEARCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN LEWIS CPCO (EVP OF LICENSURE & ACCREDITATION)
(512) 806-2861
Entity
Organization
Contact information
Practice address
10201 BROADWAY EXT, OKLAHOMA CITY, OK 73114-6217
(405) 463-0203
(405) 463-0251
Mailing address
PO BOX 16231, OKLAHOMA CITY, OK 73113-2231
(405) 463-0203
(405) 463-0251
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP2626
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100812550A
—
OK
Enumeration date
05/28/2006
Last updated
10/27/2022
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