Healthcare Provider Details
I. General information
NPI: 1902798580
Provider Name (Legal Business Name): BOSTON BRACE INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2650 E MCDOWELL RD
PHOENIX AZ
85008-3658
US
IV. Provider business mailing address
37 SHUMAN AVE
STOUGHTON MA
02072-3734
US
V. Phone/Fax
- Phone: 508-638-1172
- Fax:
- Phone: 508-588-6060
- Fax: 508-588-7944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
H
MORRISSEY
Title or Position: GENERAL MANAGER
Credential:
Phone: 508-588-6060