Provider Demographics
NPI:1598348278
Name:NEW HORIZONS ORTHOTICS & PROSTHETICS LLC
Entity Type:Organization
Organization Name:NEW HORIZONS ORTHOTICS & PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-698-0500
Mailing Address - Street 1:5609 1ST AVE STE A-2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2436
Mailing Address - Country:US
Mailing Address - Phone:308-698-0500
Mailing Address - Fax:
Practice Address - Street 1:1504 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-8245
Practice Address - Country:US
Practice Address - Phone:308-675-1802
Practice Address - Fax:308-675-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier