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Organization
CUSTOM CARE ORTHOTICS, INC
Active
Organization
CUSTOM CARE ORTHOTICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL JEAN HENTGES C.O. (OWNER/ORTHOTIST)
(612) 871-5000
Entity
Organization
Contact information
Practice address
910 E 26TH ST, 460, MINNEAPOLIS, MN 55404-4526
(612) 871-5000
(612) 871-3800
Mailing address
910 E 26TH ST, 460, MINNEAPOLIS, MN 55404-4526
(612) 871-5000
(612) 871-3800
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
02/07/2006
Last updated
08/22/2020
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