Organization
PERFORMANCE BRACING & ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA P. HUBBARD (MANAGING MEMBER)
(314) 872-3535
Entity
Organization
Contact information
Practice address
845 N NEW BALLAS CT, SUITE 120, SAINT LOUIS, MO 63141-7134
(314) 872-3535
(314) 787-0233
Mailing address
443 N NEW BALLAS RD, SUITE 220, SAINT LOUIS, MO 63141-6800
(314) 872-3535
(314) 787-0233
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
625893706
—
MO
Enumeration date
12/14/2006
Last updated
10/06/2008
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