Healthcare Provider Details

I. General information

NPI: 1356320428
Provider Name (Legal Business Name): ALABAMA PROSTHETICS AND ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 NARROW LANE PKWY
MONTGOMERY AL
36111-2654
US

IV. Provider business mailing address

PO BOX 250048
MONTGOMERY AL
36125-0048
US

V. Phone/Fax

Practice location:
  • Phone: 334-286-9919
  • Fax: 334-286-9621
Mailing address:
  • Phone: 334-286-9919
  • Fax: 334-286-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number44
License Number StateAL

VIII. Authorized Official

Name: MS. MARY THERESE POWERS-WATTS
Title or Position: PRESIDENT
Credential: CPO, CPED
Phone: 334-286-9919