Organization
NORTHLAND ORTHOPEDIC APPLICANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA M WILMS (SECRETARY TREASURER PART OWNER)
(816) 454-6060
Entity
Organization
Contact information
Practice address
4321 NE VIVION RD, SUITE 104, KANSAS CITY, MO 64119-2838
(816) 454-6060
(816) 453-6997
Mailing address
4321 NE VIVION RD, SUITE 104, KANSAS CITY, MO 64119-2838
(816) 454-6060
(816) 453-6997
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31045011
BLUE SHIELD
—
01
—
7058559
AETNA
—
Enumeration date
11/16/2006
Last updated
08/22/2020
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