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General NPI Number Information
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NPI Number | 1770778193
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Entity Type | Organization
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Legal Business Name | ADAPTIVE TECHNOLOGIES LLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2680 HENDERSON DR STE 3
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5297
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Country | US
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Telephone | 910-219-1455
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Fax | 910-219-1456
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD SUITE 120
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City | NASHVILLE
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State | TN
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Zip | 37205-2287
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Country | US
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Telephone | 615-550-8774
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Fax | 615-454-5352
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Authorized Official
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Title or Position | COO
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Name | BRADFORD GARDNER
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Credential |
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Telephone | 615-864-8783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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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 | NC
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