NPI 1962805812

Alloplastic Reconstruction

Organisation Anaplastologist Memphis, TN

Practice location

Address: 6 W Ge Patterson Ave Suite 102, Memphis, TN 38103-6413
Phone: (901) 410-5375
Fax: (800) 977-4149
Mailing address: 220 N. van Buren, Little Rock, AR 72205

Authorised official

Name: Michael D Kaczkowski
Title: President
Phone: (501) 265-0100

Registered specialties (3)

Anaplastologist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 229N00000X

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Ocularist

Eye and Vision Services Providers Taxonomy 156FX1700X

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Prosthetic/Orthotic Supplier

Suppliers Taxonomy 335E00000X Licence OPP00038 (AR)

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Registry record

NPI: 1962805812
Entity type: Organization
NPI issued: 7 Oct 2014
Record last updated: 9 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.