Healthcare Provider Details

I. General information

NPI: 1245664010
Provider Name (Legal Business Name): DBM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MADISON AVE SUITE 212
MANKATO MN
56001-5473
US

IV. Provider business mailing address

1400 MADISON AVE SUITE 212
MANKATO MN
56001-5473
US

V. Phone/Fax

Practice location:
  • Phone: 507-779-7117
  • Fax: 507-779-7118
Mailing address:
  • Phone: 507-779-7117
  • Fax: 507-779-7118

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: MARTY FRANA
Title or Position: CEO
Credential:
Phone: 507-779-7117