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
7500 DOLLARWAY RD STE 202, WHITE HALL, AR 71602-3085
(870) 534-1900
(870) 534-3187
Mailing address
2425 W 28TH AVE, PINE BLUFF, AR 71603-5051
(870) 534-1900
(870) 534-3187
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299136716
—
AR
Enumeration date
11/20/2012
Last updated
01/04/2024
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