Orthotic & Prosthetic Solutions LLC
Prosthetic/Orthotic Supplier in Jackson, MS. Organization (NPI-2).
NPI number1962014100
StatusActive
Last updated in NPPESJun 5, 2026
Details
- NPI
- 1962014100
- Entity type
- Organization (NPI-2)
- Legal business name
- Orthotic & Prosthetic Solutions LLC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2020
- Certification date
- Jun 5, 2026
- Last updated
- Jun 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
| 222Z00000X | – | – | ||
| 224P00000X | Prosthetist | – | – | |
| 1744P3200X | Specialist, Prosthetics Case Management | – | – |
Practice location
1050 N Flowood Dr Ste B4Jackson, MS 39232-9738
Phone 769-777-7440 · Fax 985-256-2599
Mailing address
7754 Florida BlvdBaton Rouge, LA 70806-4706
Phone 225-243-9736 · Fax 985-256-2599
Authorized official
Dandre Shondale Mostella
Owner
2564586071
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