Organization
AMPUTEE PROSTHETIC CLINIC, COMPANY
Active
Other names
AMPUTEE PROSTHETIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA S YOUNG (OFF. MANAGER/ BUSINESS OWNER)
(478) 474-5678
Entity
Organization
Contact information
Practice address
2400 BELLEVUE RD STE 22, DUBLIN, GA 31021-2889
(478) 246-1694
(478) 246-1690
Mailing address
4900 MERCER UNIVERSITY DR, MACON, GA 31210-6239
(478) 474-5678
(478) 474-5018
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP2910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408774069C
—
GA
Enumeration date
07/07/2006
Last updated
01/19/2024
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