Healthcare Provider Details

I. General information

NPI: 1427404722
Provider Name (Legal Business Name): PRECISION ORTHOTICS & PROSTHETICS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1557 SPRINGHILL AVENUE
MOBILE AL
36604
US

IV. Provider business mailing address

1557 SPRINGHILL AVENUE
MOBILE AL
36604
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-0400
  • Fax: 251-433-9940
Mailing address:
  • Phone: 251-433-0400
  • Fax: 251-433-9940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: CURRAN FOOSE
Title or Position: OWNER
Credential:
Phone: 251-433-0400