Organization
AKBK INC.
Active
Other names
Crockett Prosthetics and Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER PAUL KOSLOSKI CPO (OWNER)
(865) 675-2873
Entity
Organization
Contact information
Practice address
314 HOME AVE, MARYVILLE, TN 37801-3971
(865) 984-2580
(865) 984-2582
Mailing address
4503 WALKER BLVD, KNOXVILLE, TN 37917-1526
(865) 688-2626
(865) 688-3647
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
ORT0000000031
TN
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO0000000027
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4255379
BLUE CROSS BLUE SHEILD
TN
Enumeration date
11/04/2009
Last updated
03/20/2012
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