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General NPI Number Information
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NPI Number | 1881678522
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Entity Type | Organization
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Legal Business Name | STUBBS PROSTHETICS & ORTHOTICS, INC.
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 1213 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-2504
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Country | US
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Telephone | 706-259-4563
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Fax | 706-259-4775
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Provider Business Mailing Address
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Address Line | 5715 UPTAIN RD STE 5800
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5655
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Country | US
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Telephone | 423-698-1778
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Fax | 423-698-1741
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM MARK STUBBS
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Credential | CPO
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Telephone | 423-698-1778
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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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