Organization
WYOMING VALLEY PROSTHETICS AND ORTHOTICS
Active
Organization
WYOMING VALLEY PROSTHETICS AND ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANTE C MOLINO CPO (OWNER)
(570) 283-3835
Entity
Organization
Contact information
Practice address
300 AVENUE A, SWOYERSVILLE, PA 18704
(570) 283-3835
(570) 283-3805
Mailing address
300 AVENUE A, SWOYERSVILLE, PA 18704
(570) 283-3835
(570) 283-3805
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011636190003
—
PA
01
—
206119
BLUE CROSS
—
Enumeration date
02/14/2006
Last updated
08/22/2020
Update your record
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