Provider Demographics
NPI:1962038117
Name:SOLA PROSTHETICS, INC
Entity Type:Organization
Organization Name:SOLA PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUICHET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-960-9190
Mailing Address - Street 1:PO BOX 1565
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1565
Mailing Address - Country:US
Mailing Address - Phone:972-492-7652
Mailing Address - Fax:225-286-7547
Practice Address - Street 1:4541 N JOSEY LN STE 240
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4781
Practice Address - Country:US
Practice Address - Phone:214-960-9190
Practice Address - Fax:225-286-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier