Organization
CHARLESTON BRACE COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHANIEL JACKSON CO, CPED (OWNER)
(843) 871-0600
Entity
Organization
Contact information
Practice address
726 BROUGHTON ST, ORANGEBURG, SC 29115-6648
(877) 552-7223
(843) 871-0600
Mailing address
3489 LADSON RD STE C, LADSON, SC 29456-4330
(843) 871-0600
(843) 871-6510
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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