Healthcare Provider Details

I. General information

NPI: 1467515627
Provider Name (Legal Business Name): BARBARA ANN CLINTON CERTIFIED FITTER FOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 EASTERN VALLEY ROAD
BESSEMER AL
35020-8600
US

IV. Provider business mailing address

1330 EASTERN VALLEY ROAD
BESSEMER AL
35020-8600
US

V. Phone/Fax

Practice location:
  • Phone: 205-424-5280
  • Fax:
Mailing address:
  • Phone: 205-424-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: