=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770569881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIRGINIA PROSTHETICS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2005
-----------------------------------------------------
Last Update Date | 02/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1577 JEFFERSON HWY STE 101
-----------------------------------------------------
City | FISHERSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22939-2279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-949-4248
-----------------------------------------------------
Fax | 540-949-4228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4338 WILLIAMSON RD NW
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24012-2821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-366-8287
-----------------------------------------------------
Fax | 540-366-0186
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | BRADFORD NEIL GARDNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-864-8783
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------