Organization
ADVANCED PROSTHETICS OF SPARTANBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE MCGAHA (OFFICE ADMINISTRATOR)
(864) 859-4709
Entity
Organization
Contact information
Practice address
102 WILLOW LN, SPARTANBURG, SC 29307-1343
(864) 582-4411
(864) 573-6717
Mailing address
102 WILLOW LN, SPARTANBURG, SC 29307-1343
(864) 582-4411
(864) 573-6717
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE3522
—
SC
Enumeration date
05/01/2012
Last updated
09/02/2015
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