Provider Demographics
NPI:1477146868
Name:TUCSON ORTHOTICS & PROSTHETICS, LLC
Entity Type:Organization
Organization Name:TUCSON ORTHOTICS & PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:NETHER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:803-236-9931
Mailing Address - Street 1:7478 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2306
Mailing Address - Country:US
Mailing Address - Phone:520-742-4406
Mailing Address - Fax:520-742-4388
Practice Address - Street 1:7478 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2306
Practice Address - Country:US
Practice Address - Phone:520-742-4406
Practice Address - Fax:520-742-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier