Organization
SUSAN Y PELLETIER
Active
Other names
The Brace Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN Y PELLETIER (OWNER)
(817) 267-0909
Entity
Organization
Contact information
Practice address
1600 CENTRAL DR, SUITE 157, BEDFORD, TX 76022-6000
(817) 267-0909
(817) 283-1868
Mailing address
1600 CENTRAL DR, SUITE 157, BEDFORD, TX 76022-6000
(817) 267-0909
(817) 283-1868
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10020974
—
TX
Enumeration date
07/11/2006
Last updated
12/13/2013
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