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Organization

GATES PROSTHETICS & MOBILITY CLINIC CO

Active
Parent organization
GATES PROSTHETICS & MOBILITY CLINIC CO
Organization subpart
Yes

Provider details

NPI number
Legal business name
GATES PROSTHETICS & MOBILITY CLINIC CO
Authorized official
TERRAN ELIZABETH GATES CPO (OWNER, PRESIDENT)
(870) 307-2174
Entity
Organization

Contact information

Practice address
706 S WALTON BLVD STE 6, BENTONVILLE, AR 72712-5751
(479) 418-2297
Mailing address
706 S WALTON BLVD STE 6, BENTONVILLE, AR 72712-5751
(479) 418-2297

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
04/09/2024
Last updated
05/14/2024
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