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Organization

CREATIVE PEDORTHICS, LLC

Active
Other names
Arches
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KARLHEINZ REICHL CPED., BOCPED (OWNER/MANAGER)
(254) 773-2693
Entity
Organization

Contact information

Practice address
1616 AZALEA DR, SUITE 105, TEMPLE, TX 76502-2774
(254) 773-2693
Mailing address
1616 AZALEA DR, SUITE 105, TEMPLE, TX 76502-2774
(254) 773-2693

Taxonomy

Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6716820001
MEDICARE PTAN
TX
Enumeration date
06/02/2012
Last updated
01/07/2013
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