Mountain State Prosthetics, LLC
NPI #1639124423 in Charleston, West Virginia
Provider Information
- NPI Number
- 1639124423
- Entity Type
- Organization
- Organization Name
- Mountain State Prosthetics, LLC
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- May 23, 2006
- Last Updated
- Mar 15, 2012
Practice Location
- Address
- 216 BROOKS ST
- Address 2
- SUITE 100
- City
- Charleston
- State
- West Virginia
- ZIP Code
- 25301-1828
- Phone
- (304) 344-5593
Authorized Official
- Name
- DAVID P. HANSFORD, CPO
- Title
- MANAGER
- Phone
- (304) 344-5593
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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