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CUSTOM DME NPI 1255570099


NPI Information

NPI: 1255570099
Provider Name: CUSTOM DME

Other Name: FEELINGWHOLEAGAIN.COM

Classification: Anaplastologist - 229N00000X
Entity Type: Organization
Address:
1455 S 500 W STE D
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 997-0545
Get Directions

CUSTOM DME is an anaplastologist in Bountiful, UT. The provider is an anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). CUSTOM DME NPI is 1255570099. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Feelingwholeagain.com.

The provider's business location address is:

1455 S 500 W STE D
BOUNTIFUL, UT
ZIP 84010-252
Phone: (801) 997-0545
Fax: (888) 977-5399

The provider's authorized official is Paul Benjamin Tanner .
The authorized official title is Owner and has the following contact phone number (801) 997-0545.

The enumeration date for this NPI number is 2/18/2009 and was last updated on 12/4/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1156FX1700XTechnician/TechnologistOcularistNo
2229N00000XAnaplastologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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