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Organization

CERTIFIED BRACE AND LIMB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNY KEELE II CPO (OWNER)
(660) 826-3555
Entity
Organization

Contact information

Practice address
101 DUNDEE AVE, SEDALIA, MO 65301-2336
(660) 826-3555
(660) 826-9555
Mailing address
101 DUNDEE AVE, SEDALIA, MO 65301-2336
(660) 826-3555
(660) 826-9555

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
626234207
MO
Enumeration date
02/01/2010
Last updated
03/24/2015
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