NPI 1851339410

Custom Prosthetics & Orthotics

Organisation Prosthetic/Orthotic Supplier Blytheville, AR

Practice location

Address: 515 N 6th St, Blytheville, AR 72315-2407
Phone: (870) 762-5151
Fax: (870) 762-5158
Mailing address: 606 Lanes Way P.O. Box 605, Manila, AR 72442-9136

Authorised official

Name: Brandon D Harper
Title: Owner
Phone: (870) 762-5151

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence PENDING (AR)

Other Prosthetic/Orthotic Supplier providers in Arkansas →

Registry record

NPI: 1851339410
Entity type: Organization
NPI issued: 3 Jun 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.