Organization
CHARLESTON BRACE COMPANY, LLC
Active
Parent organization
CHARLESTON BRACE COMPANY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLESTON BRACE COMPANY, LLC
Authorized official
MR. NATHANIEL JACKSON CO, CPED (OWNER)
(843) 542-9000
Entity
Organization
Contact information
Practice address
111 MAGNOLIA ST, WALTERBORO, SC 29488-2911
(843) 542-9000
(843) 542-2612
Mailing address
9470 HIGHWAY 78 # A, LADSON, SC 29456-3909
(843) 871-0600
(843) 871-6510
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
015090713
SC
Other
Enumeration date
06/15/2007
Last updated
07/15/2024
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