Healthcare Provider Details

I. General information

NPI: 1972407534
Provider Name (Legal Business Name): HEALING SOLES ORTHOTICS LLC DBA FOOT SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 E COLISEUM BLVD
FORT WAYNE IN
46805-1215
US

IV. Provider business mailing address

1550 WOODSIDE CIR
FRANKLIN IN
46131-9240
US

V. Phone/Fax

Practice location:
  • Phone: 260-484-8966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LEEANN BOYANOWSKI
Title or Position: OWNER/ PARTNER
Credential:
Phone: 317-412-3463