Basic Information
| Provider Information | |||||||||
| NPI: | 1073973194 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMPRESSION OBSESSION | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 650 UNIVERSITY AVE | ||||||||
| Address2: | SUITE 109 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166490700 | ||||||||
| FaxNumber: | 9166492087 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 UNIVERSITY AVE | ||||||||
| Address2: | SUITE 109 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166490700 | ||||||||
| FaxNumber: | 9166492087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2016 | ||||||||
| LastUpdateDate: | 04/02/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FLINN | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9166490700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
| NPICertificationDate: | 04/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 335E00000X | Y | Suppliers | Prosthetic/Orthotic Supplier |
No ID Information.