Provider Demographics
NPI:1144690504
Name:APPALACHIAN PROSTHETIC & ORTHOTIC SERVICES, INC
Entity type:Organization
Organization Name:APPALACHIAN PROSTHETIC & ORTHOTIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CO, BOCO, CPED
Authorized Official - Phone:423-288-8599
Mailing Address - Street 1:3551 E STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7115
Mailing Address - Country:US
Mailing Address - Phone:423-288-8599
Mailing Address - Fax:423-288-5227
Practice Address - Street 1:750 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1923
Practice Address - Country:US
Practice Address - Phone:276-328-6200
Practice Address - Fax:423-288-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT0000000096335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier