Healthcare Provider Details
I. General information
NPI: 1831278753
Provider Name (Legal Business Name): THE WINKLEY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2835 SOUTH SERVICE ROAD DRIVE SUITE 206
RED WING MN
55066-1883
US
IV. Provider business mailing address
740 DOUGLAS DR N
GOLDEN VALLEY MN
55422-4301
US
V. Phone/Fax
- Phone: 651-212-6440
- Fax: 651-340-7676
- Phone: 763-546-1177
- Fax: 763-847-9508
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | NONE |
| License Number State | |
VIII. Authorized Official
Name: MR.
ALEXANDER
PETER
GRUMAN
Title or Position: PRESIDENT
Credential: CO
Phone: 763-546-1177