Organization
TEQUESTA BRACING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBETH BUITRAGO (CEO/DIRECTOR)
(307) 271-3030
Entity
Organization
Contact information
Practice address
151 E 1ST ST STE 141, POWELL, WY 82435-2701
(307) 271-3030
(307) 333-0082
Mailing address
151 E 1ST ST STE 141, POWELL, WY 82435-2701
(307) 271-3030
(307) 333-0082
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/09/2016
Last updated
05/16/2018
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