Organization
FOOTHILLS PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN A WICKER CPO (PRESIDENT)
(828) 391-5164
Entity
Organization
Contact information
Practice address
1603 S STERLING ST, MORGANTON, NC 28655-4097
(828) 391-5164
(828) 391-5011
Mailing address
1603 S STERLING ST, MORGANTON, NC 28655-4097
(828) 391-5164
(828) 391-5011
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704693
—
NC
Enumeration date
05/15/2007
Last updated
04/26/2022
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