Provider Demographics
NPI:1528381258
Name:AXIOBIONICS, LLC
Entity type:Organization
Organization Name:AXIOBIONICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:800-552-3539
Mailing Address - Street 1:6111 JACKSON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9167
Mailing Address - Country:US
Mailing Address - Phone:800-552-3539
Mailing Address - Fax:888-574-6888
Practice Address - Street 1:6111 JACKSON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9167
Practice Address - Country:US
Practice Address - Phone:800-552-3539
Practice Address - Fax:888-574-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICPO1050335E00000X
OHLPO76335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier