=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780828137
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORRIS LIMB AND BRACE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2009
-----------------------------------------------------
Last Update Date | 04/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 508 PAUL W BRYANT DR E
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35401-2010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-349-5388
-----------------------------------------------------
Fax | 205-752-4002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 508 PAUL W BRYANT DR E
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35401-2010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-349-5388
-----------------------------------------------------
Fax | 205-752-4002
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. TERI LEVERT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 205-349-5388
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number | 020
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------