Healthcare Provider Details

I. General information

NPI: 1699761486
Provider Name (Legal Business Name): GADSDEN LIMB & BRACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S 4TH ST
GADSDEN AL
35901-5212
US

IV. Provider business mailing address

305 S 4TH ST
GADSDEN AL
35901-5212
US

V. Phone/Fax

Practice location:
  • Phone: 256-549-0064
  • Fax: 256-549-0002
Mailing address:
  • Phone: 256-549-0064
  • Fax: 256-549-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number014
License Number StateAL

VIII. Authorized Official

Name: RICK PARTAIN
Title or Position: VICE PRESIDENT
Credential: CPO
Phone: 256-549-0064