Healthcare Provider Details
I. General information
NPI: 1154146231
Provider Name (Legal Business Name): DPM SYNC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2024
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 S MAIN ST STE 101
MISHAWAKA IN
46544-2159
US
IV. Provider business mailing address
303 S MAIN ST STE 101
MISHAWAKA IN
46544-2159
US
V. Phone/Fax
- Phone: 574-208-5508
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP1100X |
| Taxonomy | Podiatric Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIC
RINDLISBACHER
Title or Position: OWNER
Credential: DPM
Phone: 208-371-9190