Provider Demographics
NPI:1447342241
Name:ADVANCED PROSTHETICS INC
Entity type:Organization
Organization Name:ADVANCED PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, SEC-TREAS
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OA
Authorized Official - Phone:404-788-2786
Mailing Address - Street 1:3540 DULUTH PARK LANE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:404-788-2786
Mailing Address - Fax:678-474-1089
Practice Address - Street 1:3540 DULUTH PARK LANE
Practice Address - Street 2:SUITE 230
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:404-788-2786
Practice Address - Fax:678-474-1089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5778960001Medicare NSC