Healthcare Provider Details

I. General information

NPI: 1861280414
Provider Name (Legal Business Name): BOSTON BRACE INTERNATIONAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 THOMAS JOHNSON DR STE 100
FREDERICK MD
21702-5108
US

IV. Provider business mailing address

37 SHUMAN AVE
STOUGHTON MA
02072-3734
US

V. Phone/Fax

Practice location:
  • Phone: 301-682-8712
  • Fax:
Mailing address:
  • Phone: 508-638-1172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: THOMAS H MORRISSEY
Title or Position: GENERAL MANAGER
Credential:
Phone: 508-588-6060