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Individual

MR. GREGORY M SELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15340A COUNTY ROAD 66, LOXLEY, AL 36551-4130
(251) 964-8900
(251) 964-8901
Mailing address
15340-A COUNTY ROAD 66, LOXLEY, AL 36551-4130
(251) 964-8900
(251) 964-8901

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
AL
335E00000X
Prosthetic/Orthotic Supplier
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000680
AL STATE BOARD OF PHARMAC
AL
01
765
AL BOARD OF HME SERVICES
AL
01
9112
AL STATE LICENSE
AL
Enumeration date
06/12/2007
Last updated
12/17/2007
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