Organization
PRECISION ORTHOTICS & PROSTHETICS, LLC
Active
Other names
Pop Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD GARDNER (COO)
(615) 864-8783
Entity
Organization
Contact information
Practice address
8915 S PECOS RD, SUITE 18A, HENDERSON, NV 89074-7149
(702) 243-7671
(702) 259-7671
Mailing address
102 WOODMONT BLVD STE 120, NASHVILLE, TN 37205-5249
(615) 864-8790
(615) 454-5352
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100509314
MEDICAID
NV
Enumeration date
02/20/2006
Last updated
07/29/2022
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