Organization
PREMIER ORTHOTICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUSTIN POLSTON (PRESIDENT)
(502) 418-0204
Entity
Organization
Contact information
Practice address
13329 PROSPECT GLEN WAY, PROSPECT, KY 40059-8184
(502) 418-0204
Mailing address
13329 PROSPECT GLEN WAY, PROSPECT, KY 40059-8184
(502) 418-0204
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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