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General NPI Number Information
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NPI Number | 1225608797
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Entity Type | Organization
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Legal Business Name | ALABAMA ARTIFICIAL LIMB & ORTHOPEDIC SERVICE, INC.
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 10382 EXPRESS DR
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City | GULFPORT
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State | MS
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Zip | 39503-4600
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Country | US
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Telephone | 228-539-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 400
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City | NASHVILLE
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State | TN
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Zip | 37205-5217
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Country | US
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Telephone | 615-864-8790
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BRADFORD GARDNER
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Credential |
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Telephone | 615-550-8783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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