Provider Demographics
NPI:1447443551
Name:ALABAMA PROSTHETICS & ORTHOTICS, INC
Entity type:Organization
Organization Name:ALABAMA PROSTHETICS & ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:POWERWATTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPO
Authorized Official - Phone:334-361-9984
Mailing Address - Street 1:101 MEDICAL CENTER CT
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7279
Mailing Address - Country:US
Mailing Address - Phone:334-361-9984
Mailing Address - Fax:334-361-8385
Practice Address - Street 1:101 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7279
Practice Address - Country:US
Practice Address - Phone:334-361-9984
Practice Address - Fax:334-361-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL44OtherLICENSE
AL51056078OtherBCBS
AL0163330001Medicare PIN