Healthcare Provider Details

I. General information

NPI: 1831002179
Provider Name (Legal Business Name): INFINITY BRACES DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N FREMONT ST
SHENANDOAH IA
51601-1022
US

IV. Provider business mailing address

108 N FREMONT ST
SHENANDOAH IA
51601-1022
US

V. Phone/Fax

Practice location:
  • Phone: 254-220-0069
  • Fax:
Mailing address:
  • Phone: 254-220-0069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. AMIRALI ZAKIRALI
Title or Position: MANAGER
Credential:
Phone: 254-220-0069