Organization
MCKINNEY PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD RAY MCKINNEY C.P.O. (PRESIDENT)
(847) 855-0030
Entity
Organization
Contact information
Practice address
10504 W BLUEMOUND RD, WAUWATOSA, WI 53226-4332
(414) 614-3625
(847) 855-0090
Mailing address
6475 WASHINGTON ST, SUITE 100, GURNEE, IL 60031-4404
(847) 855-0030
(847) 855-0090
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82615700
—
WI
Enumeration date
06/22/2007
Last updated
08/04/2008
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