MEDICARE: POIZE CRANIAL PROSTHETICS LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1619819026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POIZE CRANIAL PROSTHETICS LLC

Provider Business Mailing Address
First Line	:	11230 HICKMAN MILLS DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64134-4203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11230 HICKMAN MILLS DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64134-4203
Country	:	US
Telephone Number	:	816-500-6637
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CIERA CANADY
Credential	:
Telephone Number	:	816-500-6637

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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