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General NPI Number Information
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NPI Number | 1184682130
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Entity Type | Organization
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Legal Business Name | NORTHERN BRACE COMPANY INC
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 610 N MICHIGAN ST SUITE 104
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City | SOUTH BEND
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State | IN
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Zip | 46601-1077
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Country | US
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Telephone | 574-233-4221
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Fax |
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Provider Business Mailing Address
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Address Line | 610 N MICHIGAN ST SUITE 104
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City | SOUTH BEND
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State | IN
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Zip | 46601-1077
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Country | US
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Telephone | 574-233-4221
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, OWNER
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Name | JAMES E BINSON
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Credential |
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Telephone | 586-755-2300
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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 |
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License Number State |
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Taxonomy #2
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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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