Provider Demographics
NPI:1447348818
Name:ORTHOTIC & PROSTHETIC SOLUTIONS
Entity type:Organization
Organization Name:ORTHOTIC & PROSTHETIC SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:MATCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:ORT L
Authorized Official - Phone:513-794-0340
Mailing Address - Street 1:11115 KENWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1817
Mailing Address - Country:US
Mailing Address - Phone:513-794-0340
Mailing Address - Fax:513-794-0341
Practice Address - Street 1:11115 KENWOOD ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-1817
Practice Address - Country:US
Practice Address - Phone:513-794-0340
Practice Address - Fax:513-794-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2573844Medicaid
KY90002254Medicaid