Organization
INNOVATIVE PROTHESTICS AND RESEARCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDSAY ANN LA FUENTE (OWNER)
(405) 740-3129
Entity
Organization
Contact information
Practice address
229 NW 9TH ST STE 104, OKLAHOMA CITY, OK 73102-2619
(405) 740-3129
Mailing address
15224 SE 73RD ST, CHOCTAW, OK 73020-5009
(405) 740-3129
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/21/2020
Last updated
09/17/2020
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