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General NPI Number Information
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NPI Number | 1518857788
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Entity Type | Organization
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Legal Business Name | CULTIVATED CONSULTANTS
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 341 MERTLE DR NE
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City | HUNTSVILLE
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State | AL
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Zip | 35810-1084
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Country | US
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Telephone | 216-220-7086
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Fax |
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Provider Business Mailing Address
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Address Line | 341 MERTLE DR NE
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City | HUNTSVILLE
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State | AL
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Zip | 35810-1084
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Country | US
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Telephone | 216-220-7086
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Fax | 216-220-7086
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Authorized Official
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Title or Position | CEO
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Name | MICHELLE COSTON
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Credential |
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Telephone | 216-220-7086
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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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