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Drew Hittenberger
Prosthetic/Orthotic Supplier in Petaluma, California
NPI 1487895975

Drew Hittenberger is a Prosthetic/Orthotic Supplier based in Santa Rosa, CA. Drew Hittenberger practices in Petaluma, CA. The NPI Number for Drew Hittenberger is 1487895975 and holds a License No. CP 1093 (California).

The current practice location address for Drew Hittenberger is 181 Lynch Creek, Petaluma, CA and can be reached out via phone at 707-765-1122 and via fax at 707-765-4571.

Location: 181 Lynch Creek, Petaluma, CA, 95405-4819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487895975
Provider Name
Drew Hittenberger
Credential
Provider Entity Type
Organization
Address
181 Lynch Creek, Petaluma, CA, 95405-4819
Phone Number
707-765-1122
Fax Number
707-765-4571
Provider Enumeration Date
03/13/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4129830001 01 CA PTAN PETALUMA
4129830006 01 CA PTAN SANTA ROSA
4129830007 01 CA PTAN KENTFIELD
4129830001 01 CA MEDICARE SUPPLIER NUMBER
institution
Provider Business Practice Location Address Details
Address
181 Lynch Creek
City
Petaluma
State
California
Zip
94954
Phone Number
707-765-1122
Fax Number
707-765-4571
person
Provider Business Mailing Address Details
Address
181 Lynch Creek
City
Petaluma
State
California
Zip
94954
Phone Number
707-765-1122
Fax Number
707-765-4571
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
CP 1093 (Delaware)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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