Provider Demographics
NPI:1154734317
Name:KESSLER-HEASLEY ARTIFICIAL LIMB CO.
Entity type:Organization
Organization Name:KESSLER-HEASLEY ARTIFICIAL LIMB CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:JON
Authorized Official - Last Name:MUGGENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-889-3222
Mailing Address - Street 1:3250 S DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6486
Mailing Address - Country:US
Mailing Address - Phone:417-889-3222
Mailing Address - Fax:417-889-3223
Practice Address - Street 1:2312 CONNECTCUT
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3039
Practice Address - Country:US
Practice Address - Phone:417-659-8488
Practice Address - Fax:417-659-8486
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KESSLER-HEASLEY ARTIFICIAL LIMB CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-05
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier