Organization
SNELL PROSTHETIC & ORTHOTIC LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANT E. SNELL LOPA (COO)
(501) 664-2624
Entity
Organization
Contact information
Practice address
3416 N COLLEGE AVE, SUITE 1, FAYETTEVILLE, AR 72703-5105
(479) 442-4435
(479) 442-5910
Mailing address
625 N UNIVERSITY AVE, LITTLE ROCK, AR 72205-2917
(501) 664-2624
(501) 664-1708
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
04734178001
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300574716
—
AR
Enumeration date
12/10/2005
Last updated
01/04/2024
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