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General NPI Number Information
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NPI Number | 1295916195
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Entity Type | Organization
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Legal Business Name | COMFORT ORTHOPEDIC FOOTWARE INC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1001 N STATE ROAD 135 SUITE D3
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City | GREENWOOD
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State | IN
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Zip | 46142-1348
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Country | US
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Telephone | 317-882-3668
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Fax | 317-882-3700
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Provider Business Mailing Address
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Address Line | 1001 N STATE ROAD 135 SUITE D3
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City | GREENWOOD
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State | IN
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Zip | 46142-1348
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Country | US
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Telephone | 317-882-3668
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Fax | 317-882-3700
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP BAUGHMAN
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Credential | PEDORTHIST
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Telephone | 317-882-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 332BC3200X
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License Number State | IN
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