OrganizationActive
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NPI 1225627185 · Prosthetic/Orthotic Supplier · Indianapolis, IN
Provider details
- NPI number
- 1225627185
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Dominique Hensley, Owner(317) 998-0991
Specialties & taxonomies
Suppliers
Practice location
4041 N Audubon Rd
Indianapolis, IN 46226-4740
Phone: (317) 998-0991
Approximate (ZIP-level) locationGet directions
Mailing address
4041 N Audubon Rd
Indianapolis, IN 46226-4740
Registry dates
- Enumerated
- 2021-01-14
- Last updated
- 2021-01-14
- Certified
- 2021-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.