Healthcare Provider Details

I. General information

NPI: 1225033053
Provider Name (Legal Business Name): THE FITTING PLACE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 22ND ST
WEST DES MOINES IA
50266-1403
US

IV. Provider business mailing address

1440 22ND ST
WEST DES MOINES IA
50266-1403
US

V. Phone/Fax

Practice location:
  • Phone: 515-225-3043
  • Fax: 515-225-0184
Mailing address:
  • Phone: 515-225-3043
  • Fax: 515-225-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. KAI ANDREW CARLSON
Title or Position: PRESIDENT
Credential: C. PED
Phone: 515-225-3043