Organization
BRACE 4 IT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK L POLK (MEMBER)
(256) 881-4158
Entity
Organization
Contact information
Practice address
3058 LEEMAN FERRY RD SW, SUITE L, HUNTSVILLE, AL 35801-6520
(256) 881-4158
(256) 881-4196
Mailing address
3058 LEEMAN FERRY RD SW, SUITE L, HUNTSVILLE, AL 35801-6520
(256) 881-4158
(256) 881-4196
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AL
Other
Enumeration date
09/04/2006
Last updated
08/22/2020
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