Organization
ADA ARTIFICIAL LIMB & BRACE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD FAULKNER (OWNER/LPO)
(580) 332-7275
Entity
Organization
Contact information
Practice address
2727 ARLINGTON ST, ADA, OK 74820-2908
(580) 332-7275
(580) 332-4838
Mailing address
2727 ARLINGTON ST, ADA, OK 74820-2908
(580) 332-7275
(580) 332-4838
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
25
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731432989-001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
11/28/2007
Last updated
11/29/2007
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