Provider Demographics
NPI:1568238350
Name:FIRST CHOICE ORTHOTICS PROSTHETICS AND DME
Entity Type:Organization
Organization Name:FIRST CHOICE ORTHOTICS PROSTHETICS AND DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMAR
Authorized Official - Middle Name:MARCELL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-820-8926
Mailing Address - Street 1:2351 STONEBRIDGE DR BLDG G
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5407
Mailing Address - Country:US
Mailing Address - Phone:810-820-8926
Mailing Address - Fax:810-820-8940
Practice Address - Street 1:202 NORTHPARK DRIVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203
Practice Address - Country:US
Practice Address - Phone:810-820-8926
Practice Address - Fax:810-820-8940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST CHOICE ORTHOTICS PROSTHETICS AND DME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier