Organization
TAMMY L DIRKSEN
Active
Other names
CENTRAL ORTHOTIC & PROSTHETIC
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY DIRKSEN CO (OWNER)
(559) 251-5557
Entity
Organization
Contact information
Practice address
2039 N FINE AVE, FRESNO, CA 93727-1512
(559) 251-5557
(559) 251-5559
Mailing address
2039 N FINE AVE, FRESNO, CA 93727-1512
(559) 251-5557
(559) 251-5559
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000650
—
CA
Enumeration date
10/04/2007
Last updated
07/12/2022
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