Organization
INNOVATIVE BRACING CONCEPTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY PEDERSON (GENERAL MANAGER)
(605) 381-1511
Entity
Organization
Contact information
Practice address
629 QUINCY ST, #100, RAPID CITY, SD 57701-0200
(605) 716-4922
(605) 716-4947
Mailing address
629 QUINCY ST, #100, RAPID CITY, SD 57701-0200
(605) 716-4922
(605) 716-4947
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/07/2013
Last updated
04/03/2014
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