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Organization

XTREME PROSTHETICS, LLC.

Active
Other names
Xtreme Prosthetics & Orthotics, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AARON E KRATOHVIL JR. C.P.O. (VP OF FINANCE, CONTROLLER)
(615) 550-8760
Entity
Organization

Contact information

Practice address
1005 WEST COLUMBIA ST, SUITE B, SOMERSET, KY 42503
(606) 451-0668
(606) 451-0078
Mailing address
1005 WEST COLUMBIA ST., SUITE B, SOMERSET, KY 42503
(606) 451-0668
(606) 451-0078

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245534585
NPI
KY
01
6469320001
PTAN
KY
Enumeration date
12/30/2010
Last updated
05/14/2021
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