Mary Diane Johnson Tmd Outlet in Lebanon - Orthotic Fitter
Mary Diane Johnson Tmd Outlet - NPI 1649389388
Mary Diane Johnson Tmd Outlet is a Orthotic Fitter in Lebanon, Missouri. Mary Diane Johnson Tmd Outlet practices all healthcare services and medical treatments related to Orthotic Fitter. The NPI Number for Mary Diane Johnson Tmd Outlet is 1649389388. The last update date is 2008-06-16.
Mary Diane Johnson Tmd Outlet's current location address is 702 S Monroe, Lebanon, Missouri. You can contact this provider via phone number 4175883404 and fax number 4175883404. The mailing address for Mary Diane Johnson Tmd Outlet is 702 S Monroe, Lebanon, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mary Diane Johnson Tmd Outlet |
|---|---|
| Address | 702 S Monroe, Lebanon, Missouri |
| Phone Number | 4175883404 |
| Fax Number | 4175883404 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/ABC |
|---|---|
| Authorized Official Name | Johnson D Mary |
| Telephone Number | 4175883404 |
NPI Number Detail
| NPI Number | 1649389388 |
|---|---|
| Provider Enumeration Date | 2006-08-29 |
| Last Updated Date | 2008-06-16 |
Provider Mailing Address Detail
| Address | 702 S Monroe |
|---|---|
| City | Lebanon |
| State | Missouri (MO) |
| Post Code | 655363570 |
| Phone Number | 4175883404 |
| Fax Number | 4175883404 |
Provider's Primary Taxonomy Detail
| Speciality | Orthotic Fitter |
|---|---|
| Taxonomy | 225000000X |
|
Definition: An individual trained in the management of fitting prefabricated orthoses. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 174584 | MO | BLUE CROSS/BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Mary Diane Johnson Tmd Outlet by the Centers for Medicare & Medicaid Services?
The Mary Diane Johnson Tmd Outlet has been assigned the NPI (National Provider Identifier) 1649389388. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Mary Diane Johnson Tmd Outlet is geographically located?
The Mary Diane Johnson Tmd Outlet is physically situated at the following location: 702 S Monroe, Lebanon, MO, 655363570.
What is Mary Diane Johnson Tmd Outlet's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Diane Johnson Tmd Outlet's area of specialization is Orthotic Fitter, and the corresponding taxonomy code that categorizes this field of practice is 225000000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1649389388 to Mary Diane Johnson Tmd Outlet?
The Mary Diane Johnson Tmd Outlet received its 1649389388 assignment from the Centers for Medicare & Medicaid Services on 2006-08-29.
When was the information regarding Mary Diane Johnson Tmd Outlet most recently updated?
The details pertaining to the Mary Diane Johnson Tmd Outlet, including its address, specialty, and other relevant information, were last refreshed on 2008-06-16.