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General NPI Number Information
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NPI Number | 1720311897
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Entity Type | Organization
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Legal Business Name | DYNAMICBRACINGSOLUTIONS, INC.
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 4373 VIEWRIDGE AVE SUITE A
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City | SAN DIEGO
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State | CA
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Zip | 92123-1619
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Country | US
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Telephone | 619-972-3853
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235267
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City | ENCINITAS
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State | CA
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Zip | 92023-5267
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Country | US
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Telephone | 619-972-3853
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Fax | 760-798-0377
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARMADUKE DAVID LOKE
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Credential |
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Telephone | 619-972-3853
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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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