Provider Demographics
NPI:1467117523
Name:CRANIAL TECHNOLOGIES, INC.
Entity Type:Organization
Organization Name:CRANIAL TECHNOLOGIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROCESS IMPROVEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:OUMOU
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-403-6374
Mailing Address - Street 1:1405 W AUTO DRIVE FL 2
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1016
Mailing Address - Country:US
Mailing Address - Phone:844-447-5894
Mailing Address - Fax:
Practice Address - Street 1:1722 SWEETWATER RD STE A
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7646
Practice Address - Country:US
Practice Address - Phone:844-447-5894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRANIAL TECHNOLOGIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier