Organization
CLARKSVILLE LIMB & BRACE & REHAB., INC.
Active
Other names
Glasgow Orthotics & Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
SUMESH SAXENA (OWNER OF BIONIC)
(219) 791-9200
Entity
Organization
Contact information
Practice address
4288 N JACKSON HWY, GLASGOW, KY 42141-9020
(270) 678-7290
(270) 678-1271
Mailing address
980 PROFESSIONAL PARK DR STE B, CLARKSVILLE, TN 37040-5251
(931) 648-2155
(931) 647-4952
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382051
ANTHEM
KY
05
—
90262569
—
KY
Enumeration date
06/20/2005
Last updated
03/02/2022
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