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General NPI Number Information
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NPI Number | 1902209190
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Entity Type | Organization
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Legal Business Name | LAS BRACES
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 154 EARLINE ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-1235
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Country | US
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Telephone | 337-407-5140
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Fax | 337-407-5151
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Provider Business Mailing Address
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Address Line | PO BOX 2503
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City | OPELOUSAS
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State | LA
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Zip | 70571-2503
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Country | US
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Telephone | 337-407-5140
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Fax | 337-407-5151
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Authorized Official
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Title or Position | OWNER
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Name | LLOYD SEMIEN
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Credential | CFO
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Telephone | 337-407-5140
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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 | LA
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