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General NPI Number Information
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NPI Number | 1457434730
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Entity Type | Organization
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Legal Business Name | TANDEM ORTHOTICS AND PROSTHETICS, INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 2380 TROOP DR SUITE 204
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City | SARTELL
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State | MN
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Zip | 56377-4636
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Country | US
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Telephone | 320-252-9211
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Fax | 320-252-9244
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | SARTELL
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State | MN
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Zip | 56377-0297
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Country | US
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Telephone | 320-252-9211
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Fax | 320-252-9244
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Authorized Official
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Title or Position | OWNER
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Name | MS. LISA M SCHOONMAKER
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Credential | CPO
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Telephone | 320-252-9211
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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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