Organization
SUMMIT CITY PROSTHETICS & ORTHOTICS INC
Active
Parent organization
SUMMIT CITY PROSTHETICS & ORTHOTICS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMIT CITY PROSTHETICS & ORTHOTICS, INC
Authorized official
MR. SHAWN DEE BROWN CPO (PRESIDENT)
(260) 312-1746
Entity
Organization
Contact information
Practice address
16597 STATE ROAD 23 STE 2, SOUTH BEND, IN 46635-1461
(574) 855-1488
(574) 387-5583
Mailing address
16597 STATE ROAD 23 STE 2, SOUTH BEND, IN 46635-1461
(574) 855-1488
(574) 387-5583
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300033323
—
IN
Enumeration date
04/19/2021
Last updated
04/19/2021
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