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Organization

BECKLEY ORTHOTICS AND PROSTHETICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID EDWARD PAYNE CPO BOCP (PRESIDENT)
(304) 254-8285
Entity
Organization

Contact information

Practice address
471 NORTH VANCE DRIVE, BECKLEY, WV 25801-0471
(304) 254-8285
(304) 254-8286
Mailing address
471 NORTH VANCE DRIVE, BECKLEY, WV 25801-0471
(304) 254-8285
(304) 254-8286

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001388710
BLUE CROSS BLUE SHIELD
WV
01
1047281
BRICKSTREET MUTUAL WORKER
WV
05
9100003000
WV
Enumeration date
11/27/2006
Last updated
10/21/2022
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