Provider Demographics
NPI:1942509450
Name:ATLANTIC PROSTHETICS & ORTHOTICS, LLC
Entity Type:Organization
Organization Name:ATLANTIC PROSTHETICS & ORTHOTICS, LLC
Other - Org Name:UNCH DEPT. OF PROSTHETICS & ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:919-945-0215
Mailing Address - Street 1:200 TIMBERHILL PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1596
Mailing Address - Country:US
Mailing Address - Phone:919-945-0215
Mailing Address - Fax:919-945-0220
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:DEPT. OF PROSTHETICS & ORTHOTICS
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4630
Practice Address - Fax:919-966-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6528340001Medicare NSC