Healthcare Provider Details

I. General information

NPI: 1356439814
Provider Name (Legal Business Name): DELABY BRACE & LIMB CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 LISBON ST
CLINTON NC
28328-4115
US

IV. Provider business mailing address

218 LISBON ST
CLINTON NC
28328-4115
US

V. Phone/Fax

Practice location:
  • Phone: 910-299-0100
  • Fax: 910-299-0101
Mailing address:
  • Phone: 910-299-0100
  • Fax: 910-299-0101

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: DAWN B. BENNER
Title or Position: PRESIDENT
Credential: CPO, C.PED
Phone: 910-299-0100