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General NPI Number Information
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NPI Number | 1154455616
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Entity Type | Organization
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Legal Business Name | KIDS ABILITIES, INC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 490 HIGHWAY 96 W SUITE 300
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City | SHOREVIEW
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State | MN
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Zip | 55126-1960
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Country | US
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Telephone | 651-451-3016
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Fax |
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Provider Business Mailing Address
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Address Line | 490 HIGHWAY 96 W SUITE 300
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City | SHOREVIEW
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State | MN
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Zip | 55126-1960
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Country | US
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Telephone | 651-451-3016
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER E. SARGENT
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Credential | P.T.
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Telephone | 651-451-3016
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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