Organization
JERALD C GIFFORD
Active
Other names
Middle Tennessee O&P, Middle Tennessee Orthotics & Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
JERALD CRAIG GIFFORD CPO, LPO (OWNER)
(615) 809-2650
Entity
Organization
Contact information
Practice address
1411 MARK ALLEN LN STE C, MURFREESBORO, TN 37129-5556
(615) 809-2650
(615) 410-7392
Mailing address
1411 MARK ALLEN LN STE C, MURFREESBORO, TN 37129-5556
(615) 809-2650
(615) 410-7392
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO77, ORT99
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q035307
—
TN
Enumeration date
01/18/2017
Last updated
10/05/2020
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