Organization
ATLANTIC BRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA P GRANT (PRESIDENT)
(919) 280-8565
Entity
Organization
Contact information
Practice address
6900 SIX FORKS RD, SUITE 109, RALEIGH, NC 27615-6427
(919) 429-8157
(919) 845-7707
Mailing address
8360 SIX FORKS RD, SUITE 204, RALEIGH, NC 27615-5077
(919) 741-3993
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
000221286
NC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/11/2011
Last updated
04/29/2020
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