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General NPI Number Information
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NPI Number | 1356328710
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Entity Type | Organization
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Legal Business Name | NEBRASKA BRACE & LIMB CO
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 W 16TH ST
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City | KEARNEY
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State | NE
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Zip | 68847-6035
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Country | US
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Telephone | 308-234-5959
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Fax | 308-234-4359
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Provider Business Mailing Address
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Address Line | 104 W 16TH ST
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City | KEARNEY
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State | NE
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Zip | 68847-6035
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Country | US
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Telephone | 308-234-5959
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Fax | 308-234-4359
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Authorized Official
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Title or Position | PRESIDENT MANAGER
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Name | MR. DALTON RAY MCCOY SR.
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Credential | BOCO CO
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Telephone | 308-234-5959
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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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