Organization
DYNAMIC PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A CHIMENTO LPO, CP (OWNER)
(918) 994-4880
Entity
Organization
Contact information
Practice address
7718 E 91ST ST STE 160, TULSA, OK 74133-6051
(918) 994-4880
(918) 994-4885
Mailing address
7718 E 91ST ST STE 160, TULSA, OK 74133-6051
(918) 994-4880
(918) 994-4885
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
44
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100812540A
—
OK
Enumeration date
04/07/2008
Last updated
05/01/2024
Update your record
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