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Organization

DYNAMIC PROSTHETIC & ORTHOTIC

Active
Parent organization
DYNAMIC PROSTHETIC & ORTHOTIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DYNAMIC PROSTHETIC & ORTHOTIC
Authorized official
MR. AMY ROOKS SMITH (MANAGER)
(423) 622-2000
Entity
Organization

Contact information

Practice address
2700 WESTSIDE DR NW, SUITE 306, CLEVELAND, TN 37312-3699
(423) 478-5093
(423) 622-2400
Mailing address
2700 WESTSIDE DR NW, SUITE 306, CLEVELAND, TN 37312-3699
(423) 478-5093
(423) 622-2400

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1454227
TN
01
4033710
BLUECARE
TN
Enumeration date
12/27/2007
Last updated
12/27/2007
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