Organization
DAYTON ARTIFICIAL LIMB CLINIC, INC
Active
Organization
DAYTON ARTIFICIAL LIMB CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY CLAY SLEMKER CPO (PRESIDENT)
(937) 898-2200
Entity
Organization
Contact information
Practice address
700 HARCO DR, CLAYTON, OH 45315-8793
(937) 898-2200
(936) 832-5361
Mailing address
700 HARCO DR, CLAYTON, OH 45315-8793
(937) 898-2200
(937) 832-5361
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO1502
OH
335E00000X
Prosthetic/Orthotic Supplier
LP0114
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020050
ANTHEM
OH
05
—
2009589
—
OH
01
—
311468023-00
BWC
OH
Enumeration date
06/13/2007
Last updated
10/21/2014
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