Organization
ARTIFICIAL LIMB AND BRACE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK S NEVILLS L.P.O. (PRESIDENT/OWNER)
(256) 236-2562
Entity
Organization
Contact information
Practice address
218 E 16TH ST, ANNISTON, AL 36207-3810
(256) 236-2562
(256) 236-2521
Mailing address
218 E 16TH ST, ANNISTON, AL 36207-3810
(256) 236-2562
(256) 236-2521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
005
AL
335E00000X
Prosthetic/Orthotic Supplier
Primary
005
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000056129
—
AL
01
—
51056129
BCBS PROVIDER NUMBER
AL
Enumeration date
05/18/2006
Last updated
02/26/2013
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