MEDICARE: BRACES R US, INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT- 5557	OH
2	332B00000X	Durable Medical Equipment & Medical Supplies	22030630	OH
3	335E00000X	Prosthetic/Orthotic Supplier	PT -5557	OH
4	332BC3200X	Customized Equipment (DME)	22 030 630	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11550039	OTHER	OH	CAQH #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629008883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRACES R US, INCORPORATED

Provider Business Mailing Address
First Line	:	3317 HARVEST RIDGE DR
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1067
Country	:	US
Telephone Number	:	419-366-6303
Fax Number	:	419-433-0604

Provider Business Practice Location Address
First Line	:	4806 TIMBER COMMONS DR
Second Line	:	SUITE C
City	:	SANDUSKY
State	:	OH
Zip	:	44870-7161
Country	:	US
Telephone Number	:	419-621-1166
Fax Number	:	419-627-4263

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	KRISTIN C ALLEN
Credential	:	PT
Telephone Number	:	419-366-6303

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	09/11/2025

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