Healthcare Provider Details

I. General information

NPI: 1780738724
Provider Name (Legal Business Name): GALSTER'S ORTHOPEDIC LABORATORIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 S CHERRY ST
PINE BLUFF AR
71601-6443
US

IV. Provider business mailing address

2407 S CHERRY ST
PINE BLUFF AR
71601-6443
US

V. Phone/Fax

Practice location:
  • Phone: 870-536-2171
  • Fax: 870-536-2183
Mailing address:
  • Phone: 870-536-2171
  • Fax: 870-536-2183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. GABRIEL M. GALSTER
Title or Position: PRESIDENT
Credential: C.P, B.O.C.P.
Phone: 870-536-2171