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General NPI Number Information
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NPI Number | 1144210600
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Entity Type | Organization
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Legal Business Name | TENNESSEE BRACE AND MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 118 SHELBYVILLE HWY
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-7128
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Country | US
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Telephone | 931-438-2777
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Fax | 931-438-2778
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Provider Business Mailing Address
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Address Line | 118 SHELBYVILLE HWY
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-7128
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Country | US
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Telephone | 931-438-2777
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Fax | 931-438-2778
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Authorized Official
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Title or Position | DIRECTOR OF OPERATION
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Name | MRS. CHRISTY JO BROWN
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Credential |
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Telephone | 931-438-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0000000652
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License Number State | TN
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