Organization
SOS BUISNESS TRUST
Active
Other names
Stagner Orthopedic Services
Organization subpart
No
Provider details
NPI number
Authorized official
BJ STAGNER JR. C.P.O. (TRUSTEE PRACTITIONER)
(615) 868-7626
Entity
Organization
Contact information
Practice address
515 STONECREST PKWY, SUITE 210, SMYRNA, TN 37167-6826
(615) 459-7560
Mailing address
3918 DICKERSON PIKE, SUITE 114, NASHVILLE, TN 37207-1328
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
3
TN
335E00000X
Prosthetic/Orthotic Supplier
4
TN
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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