Organization
CHARLESTON BRACE COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL JACKSON (OWNER)
(843) 871-0600
Entity
Organization
Contact information
Practice address
2061 HIGHWAY 52, MONCKS CORNER, SC 29461-5017
(843) 871-0600
(843) 871-6510
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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