Organization
GRAYBEAL ORTHOPEDIC LLC
Active
Parent organization
GRAYBEAL ORTHOPEDIC LLC
Other names
Anchor Brace and Limb
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAYBEAL ORTHOPEDIC LLC
Authorized official
ADAM LEE FANN CPO (MEMBER)
(423) 975-9884
Entity
Organization
Contact information
Practice address
450 PARK PL NW STE 101, NORTON, VA 24273-2127
(276) 870-9952
(276) 444-4679
Mailing address
107 E MYRTLE AVE, JOHNSON CITY, TN 37601-4631
(423) 975-9884
(423) 975-6678
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452173
—
TN
Enumeration date
11/07/2022
Last updated
11/07/2022
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