Organization
PROSTHETIX SHOP LLC
Active
Other names
Prosthetix Shop LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CONCETTA ELIZABETH BISHOP (OFFICE MANAGER)
(513) 843-5126
Entity
Organization
Contact information
Practice address
2853 BROADWAY, URBANCREST, OH 43123-1400
(614) 500-4215
(614) 500-4215
Mailing address
2853 BROADWAY, URBANCREST, OH 43123-1400
(614) 500-4215
(614) 500-4215
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081405
—
OH
Enumeration date
04/07/2022
Last updated
04/20/2022
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