Provider Demographics
NPI:1831514892
Name:ONE STEP CLOSER PROSTHETICS & ORTHOTICS LLC
Entity type:Organization
Organization Name:ONE STEP CLOSER PROSTHETICS & ORTHOTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCP
Authorized Official - Phone:330-787-7090
Mailing Address - Street 1:6718 STURBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2189
Mailing Address - Country:US
Mailing Address - Phone:330-757-8023
Mailing Address - Fax:
Practice Address - Street 1:263 W MCKINLEY WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1696
Practice Address - Country:US
Practice Address - Phone:330-787-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLP 46335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier