Organization
PREMIER ORTHOTICS & PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN DIXON CPO (CEO/OWNER)
(404) 292-4200
Entity
Organization
Contact information
Practice address
753 N INDIAN CREEK DR, CLARKSTON, GA 30021-2347
(404) 292-4200
(404) 292-4247
Mailing address
753 N INDIAN CREEK DR, CLARKSTON, GA 30021-2347
(404) 292-4200
(404) 292-4247
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
0078
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00846513A
—
GA
Enumeration date
11/16/2007
Last updated
11/16/2007
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