PARK CITY PEDORTHICS NPI 1407492671

NPI Information

NPI: 1407492671
Provider Name: PARK CITY PEDORTHICS
Classification: Pedorthist - 224L00000X
Entity Type: Organization
Address:
902 E 1ST ST
MERRILL, WI
ZIP 54452
Phone: (715) 203-5730
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PARK CITY PEDORTHICS is a pedorthist in Merrill, WI. The provider is an individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. PARK CITY PEDORTHICS NPI is 1407492671. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

902 E 1ST ST
MERRILL, WI
ZIP 54452-508
Phone: (715) 203-5730

The provider's authorized official is Tasha Gleason .
The authorized official title is Owner and has the following contact phone number (715) 203-5730.

The enumeration date for this NPI number is 11/22/2019 and was last updated on 1/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	224L00000X	Pedorthist				Yes
2	332B00000X	Durable Medical Equipment & Medical Supplies				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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