Organization
SRT PROSTHETICS & ORTHOTICS LLC
Active
Other names
ForMotion Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD GARDNER (DIR OF FINANCE)
(615) 864-8783
Entity
Organization
Contact information
Practice address
3802 AMELIA AVE STE B, LAFAYETTE, IN 47905-5772
(317) 296-7330
Mailing address
102 WOODMONT BLVD STE 400, NASHVILLE, TN 37205-5217
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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