Provider Demographics
NPI:1740851385
Name:J.L. ARTIFICIAL LIMB & BRACE LLC
Entity type:Organization
Organization Name:J.L. ARTIFICIAL LIMB & BRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:928-299-3130
Mailing Address - Street 1:1730 HIGHWAY 95 STE 10
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-6909
Mailing Address - Country:US
Mailing Address - Phone:928-234-7114
Mailing Address - Fax:928-299-3131
Practice Address - Street 1:1730 HIGHWAY 95 STE 10
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-6909
Practice Address - Country:US
Practice Address - Phone:928-299-3130
Practice Address - Fax:928-299-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty