Provider Demographics
NPI:1578732798
Name:PRECISION PROSTHETICS & ORTHOTICS, LLC
Entity Type:Organization
Organization Name:PRECISION PROSTHETICS & ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST/ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP/BOCPO
Authorized Official - Phone:307-237-3271
Mailing Address - Street 1:5810 E 2ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4329
Mailing Address - Country:US
Mailing Address - Phone:307-237-3271
Mailing Address - Fax:307-315-6006
Practice Address - Street 1:5810 E 2ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4329
Practice Address - Country:US
Practice Address - Phone:307-237-3271
Practice Address - Fax:307-315-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY125586000Medicaid