Organization
MIRACLE BRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CROSS (OWNER)
(503) 805-5226
Entity
Organization
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(833) 432-5639
Mailing address
4676 COMMERCIAL ST SE STE 81, SALEM, OR 97302-1902
(833) 432-5639
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
10/17/2023
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