Organization
PERFORMANCE ORTHOTICS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH WAYNE NEIGHBORS C.O., B.O.C.O. (OWNER)
(573) 268-6750
Entity
Organization
Contact information
Practice address
2409 OAKFIELD DR, COLUMBIA, MO 65202-2280
(573) 268-6750
Mailing address
2409 OAKFIELD DR, COLUMBIA, MO 65202-2280
(573) 268-6750
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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