Organization
LEDDY BRACE & SHOE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND ARDELL BLASINGAME CPED L.O. (ORTHOTIST PRESIDENT)
(325) 673-5281
Entity
Organization
Contact information
Practice address
932 N TREADAWAY BLVD, ABILENE, TX 79601-4315
(325) 673-5281
(325) 673-5282
Mailing address
932 N TREADAWAY BLVD, ABILENE, TX 79601-4315
(325) 673-5281
(325) 673-5282
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000055
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010138801
—
TX
01
—
519252
BLUE CROSS BLUE SHIELD OF
TX
Enumeration date
07/26/2005
Last updated
01/16/2013
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