Organization
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC
Active
Organization
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC
Active
Parent organization
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC
Other names
Southlake Prosthetics and Orthotics
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC
Authorized official
MR. ROBERT CRABTREE (ADMINISTRATOR)
(205) 985-4111
Entity
Organization
Contact information
Practice address
4524 SOUTHLAKE PKWY STE 26, HOOVER, AL 35244-3272
(205) 985-4111
(888) 435-9974
Mailing address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111
(205) 985-4326
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/02/2020
Last updated
02/10/2022
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