Organization
NORTHERN BRACE COMPANY INC
Active
Other names
Northern Brace Northern Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY L WEST (VICE PRESIDENT)
(574) 233-4221
Entity
Organization
Contact information
Practice address
60160 BODNAR BLVD STE. 200, MISHAWAKA, IN 46544
(574) 256-9008
(574) 256-9016
Mailing address
610 N MICHIGAN ST STE 104, SOUTH BEND, IN 46601-1078
(574) 233-4221
(574) 233-3966
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
—
100153030C
—
IN
Enumeration date
07/26/2007
Last updated
12/07/2012
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