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Organization

HEARTLAND ORTHOTIC & PROSTHETIC LAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LANCE ELIOT FAULKNER BOC CP PLP02 (OWNER)
(405) 214-1924
Entity
Organization

Contact information

Practice address
322 W MACARTHUR ST, SHAWNEE, OK 74804-1908
(405) 214-1924
(405) 214-1110
Mailing address
322 W MACARTHUR ST, SHAWNEE, OK 74804-1908
(405) 214-1924
(405) 214-1110

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C15550
OK

Other

Enumeration date
04/16/2007
Last updated
08/22/2020
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