Organization
NORTHERN BRACE COMPANY INC
Active
Other names
Northern Brace Northern Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY L WEST (VICE PRESIDENT)
(574) 277-5548
Entity
Organization
Contact information
Practice address
53880 CARMICHAEL DR, STE. 220, SOUTH BEND, IN 46635-1567
(574) 277-5548
Mailing address
610 N MICHIGAN ST, STE. 104, SOUTH BEND, IN 46601-1077
(574) 277-5548
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100153030B
—
IN
Enumeration date
05/01/2006
Last updated
12/07/2012
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