Individual provider · Type 1 NPI

Ebony Jacks

Prosthetic/Orthotic Supplier · Indianapolis, IN

NPI number 1104574896 Active

Practice location

1011 N Arlington Ave
Indianapolis, IN 46219-3223

Call (260) 508-6752 Map

Specialties and licenses

TaxonomyCodeLicense
Prosthetic/Orthotic Supplier Primary 335E00000XNone listed

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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About NPI 1104574896

Ebony Jacks's National Provider Identifier is 1104574896, issued on Mar 13, 2022. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Indianapolis, IN. The record was last updated on Jun 7, 2022.