Organization
BOLAND PROSTHETIC & ORTHOTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL A BOLAND CPO (OWNER, ORTHOTIST/PROSTHETIST)
(478) 953-2922
Entity
Organization
Contact information
Practice address
110 OSIGIAN BLVD., WARNER ROBINS, GA 31088
(478) 953-2922
(478) 953-2927
Mailing address
110 OSIGIAN BLVD., WARNER ROBINS, GA 31088
(478) 953-2922
(478) 953-2927
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
NO STATE LICENSURE
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00820751A
—
GA
05
—
00820751B
—
GA
Enumeration date
09/29/2005
Last updated
04/21/2025
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