Organization
BRACE IT O&P
Active
Organization
BRACE IT O&P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YAHVE GONZALEZ BOCO (ORTHOTIST)
(702) 478-5848
Entity
Organization
Contact information
Practice address
3170 W SAHARA AVE STE 150, LAS VEGAS, NV 89102-6004
(702) 478-5848
(702) 478-5565
Mailing address
3170 W SAHARA AVE STE 150, LAS VEGAS, NV 89102-6004
(702) 478-5848
(702) 478-5565
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/19/2018
Last updated
09/15/2022
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