Organization
ACTIVE ORTHOPEDIC BRACING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES THOMAS BUCHHOLZ C.O. (ORTHOTIST/OWNER)
(256) 534-8637
Entity
Organization
Contact information
Practice address
2745 BOB WALLACE AVE SW, STE D, HUNTSVILLE, AL 35805-4158
(256) 534-8637
(256) 704-0024
Mailing address
2745 BOB WALLACE AVE SW, STE D, HUNTSVILLE, AL 35805-4158
(256) 534-8637
(256) 704-0024
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6890
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548413073
—
AL
Enumeration date
10/28/2008
Last updated
01/08/2013
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