Provider Demographics
NPI:1952376741
Name:C.D.DENISON ORTHOPAEDIC APPLIANCE CORP.
Entity Type:Organization
Organization Name:C.D.DENISON ORTHOPAEDIC APPLIANCE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:410-321-6844
Mailing Address - Street 1:32 WEST RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2304
Mailing Address - Country:US
Mailing Address - Phone:410-321-6844
Mailing Address - Fax:410-321-6833
Practice Address - Street 1:32 WEST RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2304
Practice Address - Country:US
Practice Address - Phone:410-321-6844
Practice Address - Fax:410-321-6833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD367962400Medicaid
MD4483750001Medicare ID - Type UnspecifiedORTHOTICS/PROSTHETICS/DME