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General NPI Number Information
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NPI Number | 1982568424
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Entity Type | Organization
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Legal Business Name | MISSION ORTHOTICS LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 3444 CARRIAGE XING
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City | SAINT CHARLES
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State | MO
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Zip | 63301-3225
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Country | US
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Telephone | 314-651-4077
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Fax | 844-439-1856
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Provider Business Mailing Address
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Address Line | 3444 CARRIAGE XING
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City | SAINT CHARLES
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State | MO
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Zip | 63301-3225
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Country | US
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Telephone | 314-651-4077
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Fax | 844-439-1856
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Authorized Official
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Title or Position | CERTIFIED ORTHOTIST
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Name | MR. MARK R BOHNING
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Credential | CO, LO
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Telephone | 314-651-4077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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