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Organization
PRIMPED 365 LLC
Active
Organization
PRIMPED 365 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENEEN FRENCH WILSON (OWNER)
(540) 449-5753
Entity
Organization
Contact information
Practice address
782 NEW RIVER ROAD, SUITE 716, CHRISTIANSBURG, VA 24073
(540) 449-5753
(540) 253-8014
Mailing address
782 NEW RIVER ROAD, SUITE 716, CHRISTIANSBURG, VA 24073
(540) 449-5753
(540) 253-8014
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
09/19/2023
Last updated
07/08/2025
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