Organization
INNOVATIVE PROSTHETIC CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE A PATTON (OWNER/MANAGER)
(251) 470-0901
Entity
Organization
Contact information
Practice address
1109 WI-65 SERVICE RD N, MOBILE, AL 36618
(251) 470-0901
(251) 650-1671
Mailing address
9034B CARL LEGETT RD, GULFPORT, MS 39503-6234
(228) 604-0818
(228) 604-0815
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
535
AL
Other
Enumeration date
08/09/2011
Last updated
10/13/2011
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