Organization
FAMILY ORTHOTICS & PROSTHETICS INC.
Active
Organization
FAMILY ORTHOTICS & PROSTHETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH M VYVLECKA SR. CO,BOCPO (OWNER)
(308) 338-3550
Entity
Organization
Contact information
Practice address
4005 7TH AVE, KEARNEY, NE 68845-1305
(308) 338-3550
(308) 338-3551
Mailing address
4005 7TH AVE, KEARNEY, NE 68845-1305
(308) 338-3550
(308) 338-3551
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0579268
—
IA
01
—
08836
BCBS OF NE PROV. #
NE
05
—
10024962500
—
NE
05
—
200278950A
—
KS
Enumeration date
07/14/2006
Last updated
10/04/2022
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