Organization
DICKSON ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERNANDO LARA CPO (OWNER/CPO)
(615) 740-0177
Entity
Organization
Contact information
Practice address
127 CRESTVIEW PARK DR, SUITE 104, DICKSON, TN 37055-2855
(615) 740-0177
(615) 740-1154
Mailing address
127 CRESTVIEW PARK DR, SUITE 104, DICKSON, TN 37055-2855
(615) 740-0177
(615) 740-1154
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CPO02324
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4319966
BLUE CROSS BLUE SHIELD
TN
Enumeration date
12/22/2011
Last updated
05/07/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us