Organization
CLARKSVILLE LIMB & BRACE & REHAB., INC.
Active
Organization
CLARKSVILLE LIMB & BRACE & REHAB., INC.
Active
Other names
Bowling Green Orthotics & Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
SUMESH SAXENA (OWNER OF BIONIC)
(219) 791-9200
Entity
Organization
Contact information
Practice address
1711 ASHLEY CIR STE 8, BOWLING GREEN, KY 42104-5801
(270) 780-0073
(270) 782-9962
Mailing address
980 PROFESSIONAL PARK DR STE B, CLARKSVILLE, TN 37040-5251
(931) 648-2155
(931) 647-4952
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190035
ANTHEM
—
05
—
90262569
—
KY
Enumeration date
06/20/2005
Last updated
03/02/2022
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