Healthcare Provider Details

I. General information

NPI: 1669320495
Provider Name (Legal Business Name): ORTHOTIC & PROSTHETIC CLINICS OF AMERICA MEMPHIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2996 KATE BOND RD STE 403
BARTLETT TN
38133-4063
US

IV. Provider business mailing address

2996 KATE BOND RD STE 403
BARTLETT TN
38133-4063
US

V. Phone/Fax

Practice location:
  • Phone: 901-310-4424
  • Fax: 901-425-9643
Mailing address:
  • Phone: 901-310-4424
  • Fax: 901-425-9643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DELRICCO CRAWFORD
Title or Position: OWNER
Credential:
Phone: 901-283-0936