Organization
SMUTHERS PROSTHETICS & ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN M BERRY SR. BOCPO CP LPO (PRESIDENT CEO)
(769) 251-0555
Entity
Organization
Contact information
Practice address
114 BRIDGETON PLZ, BYRAM, MS 39272-8710
(769) 251-0555
(769) 251-0366
Mailing address
445 BROOKWOOD ESTATES DR, BYRAM, MS 39272-5661
(769) 251-0555
(769) 251-0366
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940224
—
AL
05
—
03173827
—
MS
05
—
158078716
—
AR
05
—
1612553
—
LA
Enumeration date
01/31/2006
Last updated
06/23/2016
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