Organization
O & P CLINICAL TECHNOLOGIES, INC.
Active
Other names
Pinnacle Orthotic & Prosthetic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL E PRUSAKOWSKI LPO, CPO, FAAOP (PRESIDENT/CEO)
(352) 331-4221
Entity
Organization
Contact information
Practice address
5959 SHALLOWFORD RD STE 215, CHATTANOOGA, TN 37421-2215
(423) 648-4898
(423) 499-4979
Mailing address
5959 SHALLOWFORD RD STE 215, CHATTANOOGA, TN 37421-2215
(423) 648-4898
(423) 499-4979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
000053
GA
332BC3200X
Customized Equipment (DME)
121
TN
335E00000X
Prosthetic/Orthotic Supplier
Primary
100
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034877323
DUNS
—
05
—
1524374
—
TN
01
—
75VX6
CAGE
—
Enumeration date
03/21/2011
Last updated
01/17/2020
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