Precision Orthotic Laboratories, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

CO003684 Issued in CA

Legal business name

PRECISION ORTHOTIC LABORATORIES, INC.

Practice address

1057 R St
Fresno, CA 93721-1312

Phone

(559) 441-7282

Fax

(559) 441-7209

NPI assigned

Dec 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brian Kevin Crowder Sr., CO

Title

President

Phone

(559) 441-7282

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881756674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 R ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211312",
            "telephone_number": "559-441-7282",
            "fax_number": "559-441-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 R ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211312",
            "telephone_number": "559-441-7282",
            "fax_number": "559-441-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION ORTHOTIC LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-441-7282",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "CO003684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XA0153181",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Fresno, CA
• Providers in Fresno, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.