Organization
TENNESSEE LIMB AND BRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY D DAVIDSON (MEMBER)
(931) 854-9455
Entity
Organization
Contact information
Practice address
735 W JACKSON ST, COOKEVILLE, TN 38501-3993
(931) 854-9455
Mailing address
735 W JACKSON ST, COOKEVILLE, TN 38501-3993
(931) 854-9455
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
ORT-6
TN
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO-7
TN
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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