Provider Demographics
NPI:1689678179
Name:SVETZ ORTHOTICS & PROSTHETICS, INC
Entity Type:Organization
Organization Name:SVETZ ORTHOTICS & PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SVETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-834-1448
Mailing Address - Street 1:600 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4049
Mailing Address - Country:US
Mailing Address - Phone:724-834-1448
Mailing Address - Fax:724-834-4788
Practice Address - Street 1:600 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4049
Practice Address - Country:US
Practice Address - Phone:724-834-1448
Practice Address - Fax:724-834-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006054335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018794930001Medicaid
PA4324390001Medicare ID - Type Unspecified