Organization
ACTIVE BRACE AND LIMB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCOTT MOSHER CO (ORTHOTIST/CO OWNER)
(231) 932-8702
Entity
Organization
Contact information
Practice address
7800 US 131 S, SUITE B, CADILLAC, MI 49601-7080
(231) 775-3577
(231) 775-3578
Mailing address
5123 N ROYAL DR, TRAVERSE CITY, MI 49684-9201
(231) 932-8702
(231) 932-8762
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/15/2009
Last updated
12/18/2013
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