Healthcare Provider Details

I. General information

NPI: 1992786941
Provider Name (Legal Business Name): ORTHOTIC CARE SERVICES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SHERMAN ST STE 299
SAINT PAUL MN
55102-2567
US

IV. Provider business mailing address

2545 CHICAGO AVE STE 412
MINNEAPOLIS MN
55404-4566
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-1480
  • Fax:
Mailing address:
  • Phone: 612-871-1480
  • Fax: 612-871-1498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateMN

VIII. Authorized Official

Name: PATRICK SCOTT HINSHON
Title or Position: OWNER
Credential: CERTIFIED ORTHOTIST
Phone: 612-871-1480