Provider Demographics
NPI:1093496978
Name:PANHANDLE PROSTHETICS & ORTHOTICS LLC
Entity Type:Organization
Organization Name:PANHANDLE PROSTHETICS & ORTHOTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:806-738-5526
Mailing Address - Street 1:3505 OLSEN BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3032
Mailing Address - Country:US
Mailing Address - Phone:806-738-5526
Mailing Address - Fax:
Practice Address - Street 1:3505 OLSEN BLVD STE 211
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3032
Practice Address - Country:US
Practice Address - Phone:940-768-8788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier