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General NPI Number Information
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NPI Number | 1477410389
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Entity Type | Organization
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Legal Business Name | CRANIAL TECHNOLOGIES, INC.
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 150 OLDE GREENWICH DR STE 204
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-4002
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Country | US
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Telephone | 804-330-2414
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Fax | 844-447-5894
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Provider Business Mailing Address
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Address Line | 1405 W AUTO DR FL 2
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City | TEMPE
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State | AZ
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Zip | 85284-1227
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Country | US
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Telephone | 844-447-5894
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Fax | 844-447-5895
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Authorized Official
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Title or Position | MEDICAID SPECIALIST
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Name | OUMOU K BAH
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Credential |
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Telephone | 602-393-8188
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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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