Organization
LEO DANNY DIPIPRIMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO D DIPRIMA (OWNER)
(706) 291-7457
Entity
Organization
Contact information
Practice address
931 N 2ND AVE NW, ROME, GA 30165-2501
(706) 291-7457
Mailing address
931 N 2ND AVE NW, ROME, GA 30165-2501
(706) 291-7457
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
20140
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
631286253A
—
GA
05
—
631286253B
—
GA
Enumeration date
05/20/2006
Last updated
05/01/2013
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