Organization
CHARLESTON BRACE COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL ATHA JACKSON (OWNER)
(843) 871-0600
Entity
Organization
Contact information
Practice address
9470A HIGHWAY 78, LADSON, SC 29456-3909
(843) 871-0600
(843) 871-6510
Mailing address
9470A HIGHWAY 78, LADSON, SC 29456-3909
(843) 871-0600
(843) 871-6510
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
010748453
SC
Other
Enumeration date
10/02/2006
Last updated
07/15/2024
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