Organization
SRT PROSTHETICS & ORTHOTICS LLC
Active
Other names
ForMotion Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE SIEBENALER (DIRECTOR OF OPERATIONS)
(866) 633-3961
Entity
Organization
Contact information
Practice address
8936 SOUTHPOINTE DR, SUITE B-1, INDIANAPOLIS, IN 46227-7507
(866) 633-3961
(419) 633-3981
Mailing address
102 WOODMONT BLVD STE 400, NASHVILLE, TN 37205-5217
(615) 550-8774
(615) 454-5352
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360760J
—
IN
Enumeration date
09/11/2012
Last updated
02/23/2026
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