Organization
BACK BRACE SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA HUNTER PASCHAL (OWNER)
(901) 619-2297
Entity
Organization
Contact information
Practice address
670 S WHITE STATION RD, MEMPHIS, TN 38117-4527
(901) 619-2297
Mailing address
670 S WHITE STATION RD, MEMPHIS, TN 38117-4527
(901) 619-2297
(901) 763-2909
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
11/05/2020
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