Organization
ABANA ORTHOTICS & PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CESAR SALIM LUTFALLAH CPO, BOCPO, CPED (OWNER-PRESIDENT)
(318) 767-1929
Entity
Organization
Contact information
Practice address
1419 PETERMAN DR, ALEXANDRIA, LA 71301-3433
(318) 767-1929
(318) 767-1385
Mailing address
1419 PETERMAN DR, ALEXANDRIA, LA 71301-3433
(318) 767-1929
(318) 767-1385
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1106194
—
LA
01
—
G0568
BCBS OF LOUISIANA
LA
Enumeration date
02/01/2007
Last updated
08/27/2007
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