Organization
BUFFALO ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY BRUCE HUSOM C.PED., C.O., OST (ORTHOTIST/OWNER)
(763) 684-1800
Entity
Organization
Contact information
Practice address
112 1ST ST S, BUFFALO, MN 55313-1402
(763) 684-1800
Mailing address
112 1ST ST S, BUFFALO, MN 55313-1402
(763) 684-1800
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1044066
PREFERRED ONE
MN
01
—
32773DA
BCBS #
MN
01
—
74624
HEALTH PARTNERS
MN
01
—
8200189
MEDICA
MN
Enumeration date
08/23/2006
Last updated
08/22/2020
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