Summit City Prosthetics & Orthotics INC
Prosthetic/Orthotic Supplier in South Bend, IN. Organization (NPI-2).
NPI number1184205379
StatusActive
Last updated in NPPESApr 19, 2021
Details
- NPI
- 1184205379
- Entity type
- Organization (NPI-2)
- Legal business name
- Summit City Prosthetics & Orthotics INC
- Organization subpart
- Yes
- Enumeration date
- Apr 19, 2021
- Certification date
- Apr 19, 2021
- Last updated
- Apr 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
Practice location
16597 State Road 23 Ste 2South Bend, IN 46635-1461
Phone 574-855-1488 · Fax 574-387-5583
Mailing address
16597 State Road 23 Ste 2South Bend, IN 46635-1461
Phone 574-855-1488 · Fax 574-387-5583
Authorized official
Shawn Dee Brown
President
2603121746
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All 9 Prosthetic/Orthotic Supplier providers in South Bend · All 3,973 providers in South Bend
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