Provider Demographics
NPI:1922863117
Name:PATRIOT PROSTHETICS AND ORTHOTICS, INC.
Entity type:Organization
Organization Name:PATRIOT PROSTHETICS AND ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-577-6778
Mailing Address - Street 1:1804 COMMONS CIR STE A
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9525
Mailing Address - Country:US
Mailing Address - Phone:405-577-6778
Mailing Address - Fax:405-577-6799
Practice Address - Street 1:2305 S I 35 SERVICE RD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2775
Practice Address - Country:US
Practice Address - Phone:405-703-1472
Practice Address - Fax:405-703-1653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRIOT PROSTHETICS AND ORTHOTICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier