MEDICARE: CRANIAL TECHNOLOGIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1710465166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRANIAL TECHNOLOGIES INC

Provider Business Mailing Address
First Line	:	1405 W AUTO DR FL 2
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-1016
Country	:	US
Telephone Number	:	844-447-5894
Fax Number	:	844-447-5895

Provider Business Practice Location Address
First Line	:	10603 N MERIDIAN ST STE 120
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1055
Country	:	US
Telephone Number	:	844-447-5894
Fax Number	:	844-447-5895

Authorized Official
Title or Position	:	COMPLIANCE SPECIALIST
Name	:	CARYN MOLSBERRY
Credential	:
Telephone Number	:	480-403-6374

Provider Enumeration Date	:	07/29/2018
Last Update Date	:	08/24/2021

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Directions to “CRANIAL TECHNOLOGIES INC ” Practice Location

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