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General NPI Number Information
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NPI Number | 1669040861
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Entity Type | Organization
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Legal Business Name | SOUTHERN ORTHOCARE, INC
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1406 TUSCULUM BLVD STE 2003
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City | GREENEVILLE
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State | TN
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Zip | 37745-4341
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Country | US
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Telephone | 423-657-1400
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Fax | 423-657-1401
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Provider Business Mailing Address
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Address Line | 622 W 1ST NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-4544
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Country | US
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Telephone | 423-307-1890
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH HUNSTMAN
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Credential |
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Telephone | 423-307-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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