Organization
LIFESTYLES ORTHOTICS AND PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY ROOF (ADM MANAGER)
(402) 393-2354
Entity
Organization
Contact information
Practice address
6157 CENTER ST, OMAHA, NE 68106-2935
(402) 561-0922
(402) 561-0927
Mailing address
6157 CENTER ST, OMAHA, NE 68106-2935
(402) 561-0922
(402) 561-0927
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0906123
—
IA
Enumeration date
05/17/2007
Last updated
08/22/2020
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