Organization
VICTORY ORTHOTICS & PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD GARDNER (COO)
(615) 864-8790
Entity
Organization
Contact information
Practice address
2 SHERIDAN SQ, SUITE 100, KINGSPORT, TN 37660
(423) 378-3320
(423) 378-3363
Mailing address
2 SHERIDAN SQ, SUITE 100, KINGSPORT, TN 37660-7399
(423) 378-3320
(423) 378-3363
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454184
—
TN
01
—
4017529
BCBST
TN
05
—
9190601
—
VA
Enumeration date
03/04/2009
Last updated
10/03/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us