Organization
SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.
Active
Parent organization
SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.
Authorized official
MR. FRANK DOMINICK III CP (OWNER)
(570) 743-1414
Entity
Organization
Contact information
Practice address
550 W COLLEGE AVE, SUITE A, PLEASANT GAP, PA 16823-7401
(814) 359-1244
(814) 359-1232
Mailing address
PO BOX 243, SHAMOKIN DAM, PA 17876-0243
(570) 743-1414
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
6000007083
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018173000002
—
PA
01
—
1511123
GATEWAY
PA
01
—
2477665
AETNA
PA
01
—
28389
DIMENSIONS
PA
01
—
340622
HEALTH AMERICA
PA
01
—
39HA76
CAPITAL BLUE CROSS
PA
01
—
57492
GEISINGER HEALTH PLAN
PA
Enumeration date
01/18/2008
Last updated
02/12/2009
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