Organization
ORA ORTHOPEDICS, PC
Active
Parent organization
ORA ORTHOPEDICS, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORA ORTHOPEDICS, PC
Authorized official
KENNETH BROCKMAN (CEO)
(563) 322-0971
Entity
Organization
Contact information
Practice address
1414 W LOMBARD ST, DAVENPORT, IA 52804-2148
(563) 322-0971
(563) 324-0615
Mailing address
2300 53RD AVE, SUITE 100, BETTENDORF, IA 52722-7564
(563) 322-0971
(563) 324-0615
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207RR0500X
Rheumatology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
060006850
IL
246Z00000X
Other Specialist/Technologist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073734
—
IA
Enumeration date
01/27/2006
Last updated
12/09/2010
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