=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023092475
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TWIN CITIES ORTHOTIC & PROSTHETIC SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2005
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 709 MIDWAY AVE
-----------------------------------------------------
City | SAINT JOSEPH
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49085-2438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-983-6118
-----------------------------------------------------
Fax | 269-983-7577
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 709 MIDWAY AVE
-----------------------------------------------------
City | SAINT JOSEPH
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49085-2438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-983-6118
-----------------------------------------------------
Fax | 269-983-7577
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES OWNER
-----------------------------------------------------
Name | MR. STEVE CARL HART
-----------------------------------------------------
Credential | CPO
-----------------------------------------------------
Telephone | 269-983-6118
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225000000X
-----------------------------------------------------
Taxonomy Name | Orthotic Fitter
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 222Z00000X
-----------------------------------------------------
Taxonomy Name | Orthotist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------