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Organization

SRT PROSTHETICS & ORTHOTICS LLC

Active
Other names
ForMotion Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE SIEBENALER (DIRECTOR OF OPERATIONS)
(866) 633-3961
Entity
Organization

Contact information

Practice address
3301 W BETHEL AVE, MUNCIE, IN 47304-5402
(419) 633-3961
(419) 633-3981
Mailing address
102 WOODMONT BLVD STE 400, NASHVILLE, TN 37205-5217
(615) 550-8774
(615) 454-5352

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200360760G
IN
Enumeration date
07/13/2011
Last updated
02/23/2026
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