SOUTHEASTERN ORTHOTICS & PROSTHETICS INC NPI 1679572655

NPI Information

  • NPI: 1679572655
  • Provider Name: SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
  • Classification: Prosthetic/Orthotic Supplier - 335E00000X
  • Entity Type: Organization
  • Doing Business As: SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
  • CLIA Number: 44D2053806
  • Address: 316 N HOLTZCLAW AVE
    CHATTANOOGA, TN
    ZIP 37404
  • Phone: (423) 698-0184

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NPI Details

SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC is a prosthetic orthotic supplier in Chattanooga, TN. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC NPI is 1679572655. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeastern Orthotics & Prosthetics, Inc.

The provider's business location address is:

316 N HOLTZCLAW AVE
CHATTANOOGA, TN
ZIP 37404-305
Phone: (423) 698-0184
Fax: (423) 698-0568

The provider's authorized official is Lauren Vaughn .
The authorized official title is Vp Of Operations and has the following contact phone number (615) 890-2160.

The CLIA number assigned to this NPI record is 44D2053806 - other - clinical research office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2005 and was last updated on 1/18/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1224P00000XProsthetistNo
2335E00000XProsthetic/Orthotic SupplierTENNESSEEYes

What is NPI?

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This page was last updated on: 11/21/2025

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