Organization
PROFESSIONAL ORTHOTIC & PROSTHETIC SERVICES, LLC
Active
Other names
HeartLand O&P
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON LEE SMITH CP, BOCO (OWNER)
(785) 375-7458
Entity
Organization
Contact information
Practice address
919 WESTPORT PL, MANHATTAN, KS 66502-2913
(785) 320-2320
(785) 320-2321
Mailing address
262 JOHNSON RD UNIT A, MANHATTAN, KS 66502-1516
(785) 320-5293
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C50162
BOC
KS
01
—
CP004340
ABC
KS
Enumeration date
06/14/2019
Last updated
10/07/2019
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