Organization
LEVEL FOUR ORTHOTICS & PROSTHETICS, INC.
Active
Other names
Restore POC
Organization subpart
No
Provider details
NPI number
Authorized official
JANET WOODALL (DIRECTOR, CONTRACTING)
(336) 397-0993
Entity
Organization
Contact information
Practice address
1673 WESTBROOK PLAZA DR STE 230, WINSTON SALEM, NC 27103-3068
(336) 765-2425
(336) 765-8370
Mailing address
2534 EMPIRE DR, WINSTON SALEM, NC 27103-6710
(336) 397-2165
(336) 397-2167
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
NA
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0340W
BCBS PROVIDER NUMBER
NC
05
—
1902801244
—
NC
05
—
7703969
—
NC
01
—
87738
MULTIPLAN
—
01
—
LEVE9603-000
LINKIA
NC
05
—
VA010052734
—
VA
Enumeration date
06/14/2005
Last updated
05/15/2020
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