Organization
INLINE ORTHOTIC & PROSTHETIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT JOSEPH BARRACK C.P.O. (CEO/CERTIFIED PROSTHETIST/ORTHOTIST)
(619) 667-7000
Entity
Organization
Contact information
Practice address
5360 JACKSON DR, STE 110, LA MESA, CA 91942-6002
(619) 667-7000
(619) 667-4315
Mailing address
5360 JACKSON DR, STE 110, LA MESA, CA 91942-6002
(619) 667-7000
(619) 667-4315
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0012131
—
CA
Enumeration date
10/03/2006
Last updated
08/22/2020
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