Organization
EASTERN IOWA ORTHOTICS & PROSTHETICS, LLC
Active
Organization
EASTERN IOWA ORTHOTICS & PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD KENNETH HORSFALL CPO (DIRECTOR)
(563) 391-6789
Entity
Organization
Contact information
Practice address
5000 TREMONT AVE, STE 201, DAVENPORT, IA 52807-1007
(563) 391-6789
(563) 391-4673
Mailing address
5000 TREMONT AVE, STE 201, DAVENPORT, IA 52807-1007
(563) 391-6789
(563) 391-4673
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0443762
—
IA
Enumeration date
06/01/2005
Last updated
10/16/2008
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