Organization
PETTIES & ASSOCIATES ORTHOTIC / PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTIS V. PETTIES SR. CPO/FAAOP (PRESIDENT)
(901) 270-5470
Entity
Organization
Contact information
Practice address
1089 EASTMORELAND AVE, MEMPHIS, TN 38104-3334
(901) 275-8358
(901) 525-9378
Mailing address
1089 EASTMORELAND AVE, MEMPHIS, TN 38104-3334
(901) 275-8358
(901) 525-9378
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
188 / 230
TN
Other
Enumeration date
04/14/2010
Last updated
12/22/2011
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