Provider Demographics
NPI:1447721865
Name:PROGRESSIVE ORTHOTIC & PROSTHETIC SERVICES, INC
Entity type:Organization
Organization Name:PROGRESSIVE ORTHOTIC & PROSTHETIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-786-7701
Mailing Address - Street 1:9511 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-7201
Mailing Address - Country:US
Mailing Address - Phone:918-663-7077
Mailing Address - Fax:
Practice Address - Street 1:2711 S ROUSE ST STE E
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6621
Practice Address - Country:US
Practice Address - Phone:918-663-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier