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Organization

EPIC PROSTHETICS AND ORTHOTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAKE COBURN DAVIS CPO, MSPO (OWNER/CLINICAL MANAGER)
(801) 820-0045
Entity
Organization

Contact information

Practice address
635 N MAIN ST STE 691, RICHFIELD, UT 84701-1895
(801) 820-0087
(801) 820-2852
Mailing address
635 N MAIN ST STE 691, RICHFIELD, UT 84701-1895
(801) 820-0087
(801) 820-2852

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
02/07/2022
Last updated
12/09/2022
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