Organization
TOM REIS PROSTHETICS LLC
Active
Organization
TOM REIS PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS W. REIS C.P. (OWNER)
(515) 254-0244
Entity
Organization
Contact information
Practice address
5460 MERLE HAY RD STE C, JOHNSTON, IA 50131-1239
(515) 254-0244
(515) 254-0309
Mailing address
5460 MERLE HAY RD STE C, JOHNSTON, IA 50131-1239
(515) 254-0244
(515) 254-0309
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP-1182
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198226
—
IA
01
—
20927
WELLMARK
IA
Enumeration date
12/14/2007
Last updated
12/14/2007
Update your record
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