National Provider Identifier Database

VICTORY ORTHOTICS PROSTHETICS LLC
Prosthetic/Orthotic Supplier

An organization which supplies or vends orthopedic appliances or apparatuses and artificial body parts used to support, align, prevent, or correct deformities or to replace or improve function of body parts.


Contact Information

VICTORY ORTHOTICS & PROSTHETICS LLC
324 STEELES RD
BRISTOL, TN37620
Phone: 423-323-1927
Fax:
Website:
Specialty Taxonomy Code
* Prosthetic/Orthotic Supplier 335E00000X

* Indicates primary specialty

NPI Profile & details for VICTORY ORTHOTICS & PROSTHETICS LLC

NPI Number 1861664047
Legal business name
LBN
VICTORY ORTHOTICS & PROSTHETICS LLC
Authorized official BRAD GARDNER - (COO)
Entity Organization
Organization subpart No
Enumeration date 03/28/2008
Last updated 10/03/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: 1454184
  • VA Medicaid: 9190601
  • TN Other: 4017529 BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for VICTORY ORTHOTICS & PROSTHETICS LLC

There are currently no reviews for VICTORY ORTHOTICS & PROSTHETICS LLC


NPIdb - Home
v2.201