Healthcare Provider Details

I. General information

NPI: 1407028244
Provider Name (Legal Business Name): BARANEK & KAPA PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 ASHER CT STE 700
EAST LANSING MI
48823-8481
US

IV. Provider business mailing address

2035 ASHER CT STE 700
EAST LANSING MI
48823-8481
US

V. Phone/Fax

Practice location:
  • Phone: 517-336-9300
  • Fax: 517-336-9301
Mailing address:
  • Phone: 517-336-9300
  • Fax: 517-336-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number1753CP
License Number StateMI

VIII. Authorized Official

Name: ROBERT IRVING CRATCH JR.
Title or Position: OWNER
Credential: C.P.
Phone: 517-336-9300