Organization
ADVANCED ANATOMICAL DESIGN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN N KRATZER LO BOCO (CO PRESIDENT)
(330) 288-0027
Entity
Organization
Contact information
Practice address
300 S STATE ST, GIRARD, OH 44420-2951
(330) 288-0027
(330) 288-0095
Mailing address
375 W MAIN ST, CANFIELD, OH 44406-1433
(330) 533-7207
(330) 533-7991
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
LO0208
OH
335E00000X
Prosthetic/Orthotic Supplier
LO0209
OH
335E00000X
Prosthetic/Orthotic Supplier
LP0122
OH
335E00000X
Prosthetic/Orthotic Supplier
LPED0061
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000230289
ANTHEM
OH
05
—
2570918
—
OH
Enumeration date
09/05/2006
Last updated
08/22/2020
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