Organization Name: | FRESNO PROSTHETIC INC |
NPI Number: | 1003866088 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM MICHAEL KING (OWNER) |
Mailing Address: | 4832 N 1st St Ste 102 Fresno |
State: | CA US |
Postal Code: | 937260524 |
Phone Number: | 5592252400 |
Fax Number: | 5592253529 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1744P3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | Prosthetics Case Management |
Taxonomy Definition: |