Organization
VIRGINIA PROSTHETICS INC
Active
Other names
Formotion Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD NEIL GARDNER (DIRECTOR)
(615) 864-8783
Entity
Organization
Contact information
Practice address
445 COMMONWEALTH BLVD E STE C, MARTINSVILLE, VA 24112-2087
(276) 634-5690
(276) 634-5691
Mailing address
4338 WILLIAMSON RD NW, ROANOKE, VA 24012-2821
(540) 366-8287
(510) 366-0186
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010029589
—
VA
Enumeration date
12/20/2005
Last updated
02/16/2026
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