865 Prosthetics, LLC
Prosthetic/Orthotic Supplier in Knoxville, TN. Organization (NPI-2).
NPI number1396556114
StatusActive
Last updated in NPPESJul 21, 2025
Details
- NPI
- 1396556114
- Entity type
- Organization (NPI-2)
- Legal business name
- 865 Prosthetics, LLC
- Organization subpart
- No
- Enumeration date
- Jan 20, 2025
- Certification date
- Jul 21, 2025
- Last updated
- Jul 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
| 224P00000X | Prosthetist | – | – |
Practice location
5416 S Middlebrook Pike Ste AKnoxville, TN 37921-5980
Phone 865-484-4134 · Fax 865-622-5254
Mailing address
5416 S Middlebrook Pike Ste AKnoxville, TN 37921-5980
Phone 865-484-4134 · Fax 865-622-5254
Authorized official
Jason L Hayden
Director Of Clinical Operations
8654844134
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