Provider Demographics
NPI:1225504459
Name:DME ORTHOTICS, LLC
Entity Type:Organization
Organization Name:DME ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-882-0058
Mailing Address - Street 1:10802 QUAIL PLAZA DR STE 300B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-3122
Mailing Address - Country:US
Mailing Address - Phone:405-882-0058
Mailing Address - Fax:
Practice Address - Street 1:10802 QUAIL PLAZA DR STE 300B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3122
Practice Address - Country:US
Practice Address - Phone:405-882-0058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty