Organization
BRISTOL ORTHOTICS & PROSTHETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA C GRAYBEAL CP (CFO)
(423) 968-4442
Entity
Organization
Contact information
Practice address
553 HIGHWAY 126, BRISTOL, TN 37620-1685
(423) 968-4442
(423) 968-4777
Mailing address
553 HIGHWAY 126, BRISTOL, TN 37620-1685
(423) 968-4442
(423) 968-4777
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009791
BLUE CROSS BLUE SHIELD
TN
05
—
009113827
—
VA
05
—
009190881
—
VA
01
—
100025761
CARITTEN
TN
01
—
1131621
UNITED MINE WORKERS
TN
01
—
141558
ANTHEM
VA
05
—
3539103
—
TN
Enumeration date
07/26/2006
Last updated
04/24/2009
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