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General NPI Number Information
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NPI Number | 1619115284
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Entity Type | Organization
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Legal Business Name | FORT SMITH ARTIFICIAL LIMB AND BRACE, INC.
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 218 VINEYARD ST
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City | HOT SPRINGS
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State | AR
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Zip | 71913-5229
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Country | US
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Telephone | 501-321-4222
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Fax | 501-321-0849
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Provider Business Mailing Address
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Address Line | 124 LEIGH CIR
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7713
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Country | US
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Telephone | 501-321-4222
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Fax | 501-321-0849
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LELAND F FELIX
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Credential | CPO, FAAOP
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Telephone | 501-321-4222
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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 | OPP00051
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License Number State | AR
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