Organization
DREW HITTENBERGER
Active
Other names
Hittenberger Orthotics and Prosthetics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DREW ARNOLD HITTENBERGER CP .BOCO (OWNER)
(707) 765-1122
Entity
Organization
Contact information
Practice address
181 LYNCH CREEK WAY, SUITE 101, PETALUMA, CA 94954-2372
(707) 765-1122
(707) 765-4571
Mailing address
181 LYNCH CREEK WAY, SUITE 101, PETALUMA, CA 94954-2372
(707) 765-1122
(707) 765-4571
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP1093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412983006
PTAN SANTA ROSA
CA
01
—
412983007
PTAN KENTIFIELD
CA
05
—
GXC000123
—
CA
Enumeration date
10/06/2010
Last updated
08/11/2016
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