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General NPI Number Information
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NPI Number | 1073191946
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Entity Type | Organization
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Legal Business Name | DELABY BRACE AND LIMB OF RALEIGH
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 3209 GRESHAM LAKE ROAD BUILDING 10 SUITE 103
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City | RALEIGH
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State | NC
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Zip | 27615
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Country | US
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Telephone | 919-867-0421
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Fax | 919-591-0094
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Provider Business Mailing Address
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Address Line | 3209 GRESHAM LAKE ROAD BUILDING 10 SUITE 103
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City | RALEIGH
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State | NC
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Zip | 27615
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Country | US
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Telephone | 919-867-0421
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Fax | 919-591-0094
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Authorized Official
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Title or Position | PRACTITIONER
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Name | DENNIS F HODGES
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Credential | CPO
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Telephone | 919-867-0421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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