Organization
POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC
Active
Parent organization
POSITIVE IMAGE PROSTHETICS&ORTHOTICS,INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
POSITIVE IMAGE PROSTHETICS&ORTHOTICS,INC
Authorized official
DAVID M PUCKETT LPO/CPO (PRESIDENT/OWNER)
(912) 354-7500
Entity
Organization
Contact information
Practice address
300 NEW RIVER PKWY, BLDG 6 SUITE 12, HARDEEVILLE, SC 29927-4450
(912) 354-7500
(912) 354-7887
Mailing address
5202 WATERS AVE, SAVANNAH, GA 31404-6230
(912) 354-7500
(912) 354-7887
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
000028
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000844698A
—
GA
01
—
1225227861
NPI
SC
01
—
1235194341
NPI
GA
05
—
DE1986
—
SC
Enumeration date
04/01/2009
Last updated
04/01/2009
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