Provider Demographics
NPI:1417055732
Name:STUBBS PROSTHETICS & ORTHOTICS, INC
Entity Type:Organization
Organization Name:STUBBS PROSTHETICS & ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-698-1778
Mailing Address - Street 1:5211 HIGHWAY 153
Mailing Address - Street 2:SUITE G
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4956
Mailing Address - Country:US
Mailing Address - Phone:423-308-0514
Mailing Address - Fax:423-308-0516
Practice Address - Street 1:5715 UPTAIN RD STE 5800
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5655
Practice Address - Country:US
Practice Address - Phone:423-698-1778
Practice Address - Fax:423-698-1741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier