Organization
PROFESSIONAL ORTHOTIC & PROSTHETIC SERVICES, LLC
Active
Other names
Heartland O&P
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON LEE SMITH CP, BOCO, MSOP (OWNER)
(785) 375-7458
Entity
Organization
Contact information
Practice address
410 GRANT AVE, CLAY CENTER, KS 67432-2942
(785) 375-7458
(785) 320-2321
Mailing address
919 WESTPORT PL, MANHATTAN, KS 66502-2913
(785) 375-7458
(785) 320-2321
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C50162
BOC ORTHOTIST CERTIFICATION
MD
01
—
CP004340
PROSTHETIST CERTIFICATION ABC
MD
Enumeration date
07/15/2019
Last updated
11/27/2023
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