Organization · Type 2 NPI
Custom Dme
Anaplastologist · Bountiful, UT
Practice location
1455 S 500 W Ste D
Bountiful, UT 84010-8252
Fax (888) 977-5399
Mailing address
3187 S 200 E
Bountiful, UT 84010-5718
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ocularist | 156FX1700X | None listed |
| Anaplastologist Primary | 229N00000X | None listed |
Anaplastologist: An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical…
Another provider at this address
About NPI 1255570099
Custom Dme's National Provider Identifier is 1255570099, issued on Feb 18, 2009. The primary taxonomy on file is Anaplastologist (229N00000X), and the practice location is in Bountiful, UT. The record was last updated on Sep 18, 2026.