Organization
BROADENED HORIZONS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK EARL FELLING EE, MBA (PRESIDENT)
(612) 851-1040
Entity
Organization
Contact information
Practice address
9025 BURTON CT NW, OFFICE SUITE, RICE, MN 56367-6602
(612) 851-1040
(866) 672-8919
Mailing address
9025 BURTON CT NW, OFFICE SUITE, RICE, MN 56367-6602
(612) 851-1040
(866) 672-8919
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
MN
335E00000X
Prosthetic/Orthotic Supplier
—
MN
Other
Enumeration date
07/25/2011
Last updated
12/09/2014
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