Organization
ALABAMA ORTHOTICS & PROSTHETICS, INC.
Active
Other names
MISSISSIPPI ORTHOTICS & PROSTHETICS,INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY O. SWANSON C.P., L.P. (PRESIDENT)
(256) 536-5625
Entity
Organization
Contact information
Practice address
3205 HIGHWAY 72 W, CORINTH, MS 38834-9398
(662) 396-4670
(662) 396-4677
Mailing address
1501 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6401
(662) 396-4670
(662) 396-4677
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440966
—
MS
01
—
20423
TLC
MS
01
—
3160016
BCBS OF TENNESSEE
MS
Enumeration date
09/22/2005
Last updated
05/18/2011
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