Organization
INNOVATIVE PROSTHETIC DESIGNS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN VINCENT UNGARO CP (PRESIDENT)
(662) 240-9700
Entity
Organization
Contact information
Practice address
523 LINCOLN RD, COLUMBUS, MS 39705-2225
(662) 240-9700
(662) 240-9928
Mailing address
PO BOX 689, AMORY, MS 38821-0689
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04057226
—
MS
Enumeration date
05/17/2006
Last updated
04/01/2008
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