Organization
FOURROUX PROSTHETICS, INC
Active
Organization
FOURROUX PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W KEITH WATSON CPO (OWNER/PRESIDENT)
(256) 534-8672
Entity
Organization
Contact information
Practice address
2743 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4103
(256) 534-8672
(800) 963-5010
Mailing address
2743 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4103
(256) 534-8672
(800) 963-5010
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
15
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000050054
—
AL
05
—
4581402
—
TN
01
—
51050054
BCBS OF ALABAMA
AL
Enumeration date
07/22/2006
Last updated
12/26/2020
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