| NPI | 1184951626 |
|---|---|
| Doing Business As | CROCKETT PROSTHETICS AND ORTHOTICS |
| Entity Type | Organization |
| Authorized Contact | PETER PAUL KOSLOSKI Owner 865-675-2873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PRO0000000027) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN ORT0000000031) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2012-03-20 |