NPI 1639124423

Mountain State Prosthetics, LLC

Organisation Prosthetic/Orthotic Supplier Charleston, WV

Practice location

Address: 216 Brooks St Suite 100, Charleston, WV 25301-1828
Phone: (304) 344-5593
Fax: (304) 344-5595

Authorised official

Name: David P. Hansford
Title: Manager
Phone: (304) 344-5593

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1639124423
Entity type: Organization
NPI issued: 23 May 2006
Record last updated: 15 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.