Organization
NORTH CAROLINA ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY JOHNCOUR (OWNER)
(919) 556-3402
Entity
Organization
Contact information
Practice address
451 RUIN CREEK RD, SUITE 102, HENDERSON, NC 27536-2878
(252) 436-2611
(252) 436-2640
Mailing address
451 RUIN CREEK RD, SUITE 102, HENDERSON, NC 27536-2878
(252) 436-2611
(252) 436-2640
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046KY
BLUE CROSS & BLUE SHIELD
NC
05
—
7703875
—
NC
Enumeration date
11/02/2006
Last updated
08/14/2018
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