Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Custom Prosthetic & Orthotic

Organization Prosthetic/Orthotic Supplier · NPI 1710147301

Custom Prosthetic & Orthotic is a Prosthetic/Orthotic Supplier in Clinton, Mississippi. Licensed in Mississippi. Registered with an NPI since 2008.

Licensed in
MS
In the registry since
2008

Practice location Address checks out

801 E Northside Dr Ste - D
Clinton, MS 39056-3663
Phone: (601) 906-1024
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X (MS)

Record details

NPI number1710147301
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Johnnie Owens — Owner President · (601) 906-1024
NPI enumeratedJune 17, 2008
Last updated in NPPESMarch 15, 2012
Mailing address801 E Northside Dr, Suite - D, Clinton, MS 39056-3663

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