Organization
ORA ORTHOPEDICS, PC
Active
Parent organization
ORA ORTHOPEDICS, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORA ORTHOPEDICS, PC
Authorized official
KENNETH BROCKMAN (CEO)
(563) 322-0971
Entity
Organization
Contact information
Practice address
621 5TH STREET, DURANT, IA 52747
(563) 785-6958
(563) 785-6929
Mailing address
2300 53RD AVE, SUITE 100, BETTENDORF, IA 52722-7564
(563) 322-0971
(563) 324-0615
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
060006850
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073734
—
IA
Enumeration date
01/17/2006
Last updated
12/09/2010
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