Healthcare Provider Details

I. General information

NPI: 1841932589
Provider Name (Legal Business Name): CRANIAL TECHNOLOGIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 MIDTOWNE ST NE STE 302
GRAND RAPIDS MI
49503-5731
US

IV. Provider business mailing address

1405 W AUTO DR FL 2
TEMPE AZ
85284-1227
US

V. Phone/Fax

Practice location:
  • Phone: 844-447-5894
  • 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 State

VIII. Authorized Official

Name: OUMOU K BAH
Title or Position: PROCESS IMPROVEMENT SPECIALIST
Credential:
Phone: 602-393-8188