Provider Demographics
NPI:1437646171
Name:AMPUTEE SOLUTIONS LLC
Entity Type:Organization
Organization Name:AMPUTEE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:423-681-0406
Mailing Address - Street 1:9208 TAMARA LN
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4569
Mailing Address - Country:US
Mailing Address - Phone:423-681-0406
Mailing Address - Fax:
Practice Address - Street 1:7401 E BRAINERD RD STE 140
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3194
Practice Address - Country:US
Practice Address - Phone:423-681-0406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier