Individual
MICHAEL PRUMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPO
Contact information
Practice address
2408 FORT HENRY DR, KINGSPORT, TN 37664-3708
(423) 246-7272
(423) 246-2803
Mailing address
2408 FORT HENRY DR, KINGSPORT, TN 37664-3708
(423) 246-7272
(423) 246-2803
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
ORT16
TN
224P00000X
Prosthetist
Primary
PRO16
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454327
—
TN
Enumeration date
05/05/2006
Last updated
01/07/2008
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