Provider Demographics
NPI:1356763742
Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Entity type:Organization
Organization Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:CP, FAAOP
Authorized Official - Phone:805-434-1600
Mailing Address - Street 1:234 HEATHER CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-8765
Mailing Address - Country:US
Mailing Address - Phone:805-434-1600
Mailing Address - Fax:805-434-1603
Practice Address - Street 1:234 HEATHER CT
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-8765
Practice Address - Country:US
Practice Address - Phone:805-434-1600
Practice Address - Fax:805-434-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO1424335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier