MEDICARE: TINDAL ORTHOTICS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier	C22321	KS

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	:	1063422400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TINDAL ORTHOTICS INC

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	785-537-8897
Fax Number	:	785-537-8893

Provider Business Practice Location Address
First Line	:	3244 KIMBALL AVE
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-2157
Country	:	US
Telephone Number	:	785-537-8897
Fax Number	:	785-537-8893

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	SHERYL S PRICE
Credential	:
Telephone Number	:	503-493-8288

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	12/12/2013

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Directions to “TINDAL ORTHOTICS INC ” Practice Location

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