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General NPI Number Information
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NPI Number | 1043373095
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Entity Type | Organization
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Legal Business Name | BYNUM SURGICAL APPLIANCES, INC.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 S COLLEGE AVE SUITE B
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City | BLOOMINGTON
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State | IN
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Zip | 47403-2500
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Country | US
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Telephone | 812-333-0518
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Fax | 812-323-3174
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Provider Business Mailing Address
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Address Line | PO BOX 5963
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City | BLOOMINGTON
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State | IN
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Zip | 47407-5963
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Country | US
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Telephone | 812-333-0518
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Fax | 812-323-3174
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Authorized Official
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Title or Position | CERTIFIED ORTHOSIST
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Name | MR. TODD A. BYNUM
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Credential | CO
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Telephone | 812-333-0518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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