Organization
BLUEGRASS BRACE SHOP, LLC
Active
Organization
BLUEGRASS BRACE SHOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA TURNER KNETSCHE (MANAGER/PART OWNER)
(859) 209-4324
Entity
Organization
Contact information
Practice address
236 W MAIN ST, SUITE 201, DANVILLE, KY 40422-1812
(859) 209-4324
Mailing address
236 W MAIN ST, SUITE 201, DANVILLE, KY 40422-1812
(859) 209-4324
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/28/2008
Last updated
10/26/2010
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