MEDICARE: ARISE ORTHOTICS & PROSTHETICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003351990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARISE ORTHOTICS & PROSTHETICS, INC.

Provider Business Mailing Address
First Line	:	8338 HIGHWAY 65 NE
Second Line	:	SUITE E
City	:	SPRING LAKE PARK
State	:	MN
Zip	:	55432-1364
Country	:	US
Telephone Number	:	763-755-9500
Fax Number	:	763-755-9510

Provider Business Practice Location Address
First Line	:	8338 HIGHWAY 65 NE
Second Line	:	SUITE E
City	:	SPRING LAKE PARK
State	:	MN
Zip	:	55432-1364
Country	:	US
Telephone Number	:	763-755-9500
Fax Number	:	763-755-9510

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	THERESE KUFFEL
Credential	:
Telephone Number	:	763-755-9500

Provider Enumeration Date	:	12/30/2016
Last Update Date	:	02/01/2018

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