Provider Demographics
NPI:1457729584
Name:ASPIRE PROSTHETICS & ORTHOTICS INC.
Entity Type:Organization
Organization Name:ASPIRE PROSTHETICS & ORTHOTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KNITTEL
Authorized Official - Middle Name:KOFI
Authorized Official - Last Name:ANSA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:717-430-6100
Mailing Address - Street 1:506 GREENBRIAR RD.
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404
Mailing Address - Country:US
Mailing Address - Phone:717-430-6100
Mailing Address - Fax:717-347-6566
Practice Address - Street 1:506 GREENBRIAR RD.
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404
Practice Address - Country:US
Practice Address - Phone:717-430-6100
Practice Address - Fax:717-347-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-06
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6680097 00Medicaid
PA103094792 0001Medicaid
MD7488150001Medicare PIN
PA103094792 0001Medicaid