# SPIRIT PROSTHETICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992976013
- **Authorized official:** MR. BRIAN D JOHNSON CP, LP (OWNER/PROSTHETIST)
- **Authorized official phone:** (865) 363-3513

## Contact information

- **Practice address:** 211 E BLOUNT AVE, SUITE 701, KNOXVILLE, TN 37920-1614
- **Practice address phone:** (865) 549-4599
- **Practice address fax:** (865) 549-4598
- **Mailing address:** 4728 TILLERY RD, KNOXVILLE, TN 37912-5400
- **Mailing address phone:** (865) 363-3513
- **Mailing address fax:** (865) 549-4598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0900X | Amputee Clinic/Center | PRO0000000113 | TN | Yes |

## Other

- **Enumeration date:** 03/17/2008
- **Last updated:** 03/17/2008