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General NPI Number Information
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NPI Number | 1457551236
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Entity Type | Organization
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Legal Business Name | BRANNE LLC
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 5262 FAIRFIELD SHOPPING CTR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4212
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Country | US
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Telephone | 757-474-4220
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Fax | 757-474-2199
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Provider Business Mailing Address
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Address Line | 5262 FAIRFIELD SHOPPING CTR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4212
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Country | US
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Telephone | 757-474-4220
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Fax |
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Authorized Official
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Title or Position | OWNER/CPED
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Name | TODD PERRY
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Credential | CPED.
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Telephone | 757-474-4220
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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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