Provider Demographics
NPI:1699393850
Name:BIONIC INNOVATIONS LLC
Entity Type:Organization
Organization Name:BIONIC INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-409-4752
Mailing Address - Street 1:365 S LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-3503
Mailing Address - Country:US
Mailing Address - Phone:540-221-6190
Mailing Address - Fax:540-451-7933
Practice Address - Street 1:365 S LINDEN AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3503
Practice Address - Country:US
Practice Address - Phone:540-221-6190
Practice Address - Fax:540-451-7933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier