Provider Demographics
NPI:1497183966
Name:PROSTHETIC CONCEPTS LLC
Entity Type:Organization
Organization Name:PROSTHETIC CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:434-528-1000
Mailing Address - Street 1:2201 LANGHORNE ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1125
Mailing Address - Country:US
Mailing Address - Phone:434-528-1000
Mailing Address - Fax:434-528-1011
Practice Address - Street 1:2201 LANGHORNE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1125
Practice Address - Country:US
Practice Address - Phone:434-528-1000
Practice Address - Fax:434-528-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier