Organization
XTREME PROSTHETICS LLC.
Active
Organization
XTREME PROSTHETICS LLC.
Active
Other names
ForMotion Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD NEIL GARDNER (DIRECTOR)
(615) 864-8783
Entity
Organization
Contact information
Practice address
400 S BROADWAY ST, GLASGOW, KY 42141-2502
(270) 629-5462
Mailing address
102 WOODMONT BLVD STE 400, NASHVILLE, TN 37205-5217
(615) 550-8774
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
135770
KY
Other
Enumeration date
12/13/2016
Last updated
05/29/2026
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