Organization
UNITED ARTIFICIAL LIMB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL DAVID HOLCOMB LCPO (PARTNER)
(770) 345-6899
Entity
Organization
Contact information
Practice address
95 HICKORY SPRINGS IND DR, CANTON, GA 30115-7933
(770) 345-6899
(770) 345-7341
Mailing address
95 HICKORY SPRINGS IND DR, CANTON, GA 30115-7933
(770) 345-6899
(770) 345-7341
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
12
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000377308A
—
GA
Enumeration date
01/02/2007
Last updated
11/19/2008
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