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Organization

WILLIAMSBURG ORTHOTICS AND PROSTHETICS INC

Active
Other names
Certified Prosthetic & Orthotic Specialist
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARRY K KELLEY CPO C.PED (PRESIDENT)
(757) 833-0911
Entity
Organization

Contact information

Practice address
802 LOCKWOOD AVE, SUITE B, NEWPORT NEWS, VA 23602-4479
(757) 833-0911
(757) 833-1099
Mailing address
802 LOCKWOOD AVE, SUITE B, NEWPORT NEWS, VA 23602-4479
(757) 833-0911
(757) 833-1099

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
100478
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009190392
VA
01
116688
VERISYSTEMS
01
261848
BC/BS
VA
Enumeration date
09/26/2006
Last updated
10/18/2007
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