Provider Demographics
NPI:1386072809
Name:T-POC PR, LLC
Entity type:Organization
Organization Name:T-POC PR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-777-4789
Mailing Address - Street 1:239 AVE ARTERIAL HOSTOS
Mailing Address - Street 2:CAPTIAL CENTER BLDG, SUITE 1002
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1474
Mailing Address - Country:US
Mailing Address - Phone:787-379-6086
Mailing Address - Fax:
Practice Address - Street 1:239 AVE ARTERIAL HOSTOS
Practice Address - Street 2:CAPTIAL CENTER BLDG, SUITE 1002
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1474
Practice Address - Country:US
Practice Address - Phone:787-379-6086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PROGRESSIVE ORTHOPAEDIC COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier