Individual
JOSHUA GRAYBEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CP, LPO
Contact information
Practice address
553 HIGHWAY 126, BRISTOL, TN 37620-1685
(423) 968-4442
(423) 968-4777
Mailing address
553 HIGHWAY 126, BRISTOL, TN 37620-1685
(423) 968-4442
(423) 968-4777
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
ORT0000000023
TN
332BC3200X
Customized Equipment (DME)
Primary
PRO0000000023
TN
335E00000X
Prosthetic/Orthotic Supplier
ORT0000000023
TN
335E00000X
Prosthetic/Orthotic Supplier
PRO0000000023
TN
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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