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DESERT PROSTHETIC & ORTHOTIC REHABILITATION NPI 1962699504


NPI Information

NPI: 1962699504
Provider Name: DESERT PROSTHETIC & ORTHOTIC REHABILITATION
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
4915 E. BASELINE ROAD
SUITE 109
GILBERT, AZ
ZIP 85234
Phone: (480) 497-9929
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DESERT PROSTHETIC & ORTHOTIC REHABILITATION is a prosthetic orthotic supplier in Gilbert, AZ. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. DESERT PROSTHETIC & ORTHOTIC REHABILITATION NPI is 1962699504. The provider is registered as an organization entity type.

The provider's business location address is:

4915 E. BASELINE ROAD
SUITE 109
GILBERT, AZ
ZIP 85234
Phone: (480) 497-9929
Fax: (480) 497-9928

The provider's authorized official is Jerry Autry .
The authorized official title is Owner and has the following contact phone number (480) 497-9929.

The enumeration date for this NPI number is 9/27/2007 and was last updated on 2/22/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10188560001MEDICARE NSC
20188560001MEDICARE NSCARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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