Provider Demographics
NPI:1891572962
Name:CATALYST ORTHOTIC AND PROSTHETIC CLINIC
Entity Type:Organization
Organization Name:CATALYST ORTHOTIC AND PROSTHETIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-777-4701
Mailing Address - Street 1:3407 BERRYWOOD DR STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6697
Mailing Address - Country:US
Mailing Address - Phone:573-777-4701
Mailing Address - Fax:573-777-4702
Practice Address - Street 1:3520 S CULPEPPER CIR STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4206
Practice Address - Country:US
Practice Address - Phone:573-777-4701
Practice Address - Fax:573-777-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty