Organization
CAROLINA ORTHOTICS & PROSTHETICS OF MYRTLE BEACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARENCE RALPH HOOPER JR. CPO (CEO)
(843) 577-9577
Entity
Organization
Contact information
Practice address
9714 N KINGS HWY STE 142, MYRTLE BEACH, SC 29572-4047
(843) 497-9558
(843) 497-9130
Mailing address
3465 W MONTAGUE AVE STE 101, N CHARLESTON, SC 29418-5938
(843) 577-9577
(843) 577-9574
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE3311
—
SC
Enumeration date
03/20/2006
Last updated
08/10/2012
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