Provider Demographics
NPI:1134368566
Name:ORTHOCARE INNOVATIONS, LLC
Entity type:Organization
Organization Name:ORTHOCARE INNOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING AND FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-672-1710
Mailing Address - Street 1:840 RESEARCH PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-3637
Mailing Address - Country:US
Mailing Address - Phone:800-672-1710
Mailing Address - Fax:405-239-5372
Practice Address - Street 1:6405 218TH ST SW STE 301
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2180
Practice Address - Country:US
Practice Address - Phone:800-672-1710
Practice Address - Fax:405-239-5372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0900XAmbulatory Health Care FacilitiesClinic/CenterAmputee