Provider Demographics
NPI:1447520986
Name:ORTHOTECHNIK LLC
Entity type:Organization
Organization Name:ORTHOTECHNIK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:770-590-8233
Mailing Address - Street 1:167 SOUTH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2378
Mailing Address - Country:US
Mailing Address - Phone:770-590-8233
Mailing Address - Fax:404-583-5963
Practice Address - Street 1:167 SOUTH AVE SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2378
Practice Address - Country:US
Practice Address - Phone:770-590-8233
Practice Address - Fax:404-583-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment