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General NPI Number Information
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NPI Number | 1770621922
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Entity Type | Organization
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Legal Business Name | ABANA ORTHOTICS & PROSTHETICS INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 1419 PETERMAN DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3433
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Country | US
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Telephone | 318-767-1929
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Fax | 318-767-1385
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Provider Business Mailing Address
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Address Line | 1419 PETERMAN DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3433
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Country | US
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Telephone | 318-767-1929
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Fax | 318-767-1385
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | MR. CESAR SALIM LUTFALLAH
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Credential | CPO, BOCPO, CPED
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Telephone | 318-767-1929
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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 | LA
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