Organization
PRECISION ORTHOPEDIC TECHNOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANNON KISER (PRESIDENT)
(606) 833-9631
Entity
Organization
Contact information
Practice address
2611 GREENBO BLVD, FLATWOODS, KY 41139-1830
(606) 833-9631
Mailing address
PO BOX 937, FLATWOODS, KY 41139-0937
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000218373
BC/BS ANTHEM
KY
05
—
2288297
—
OH
05
—
6204016000
—
WV
05
—
90004284
—
KY
Enumeration date
04/25/2006
Last updated
04/20/2008
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