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General NPI Number Information
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NPI Number | 1962042440
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Entity Type | Organization
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Legal Business Name | FOURROUX PROSTHETICS, INC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 9665 PAGE AVENUE
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City | OVERLAND
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State | MO
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Zip | 63132
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Country | US
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Telephone | 314-551-2341
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Fax | 800-963-5010
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Provider Business Mailing Address
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Address Line | 2743 BOB WALLACE AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35805-4103
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Country | US
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Telephone | 256-534-8672
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Fax | 800-963-5010
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. W KEITH WATSON
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Credential | CPO
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Telephone | 256-534-8672
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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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