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General NPI Number Information
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NPI Number | 1922433358
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Entity Type | Organization
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Legal Business Name | LBS BRACES
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 5915 WASHINGTON AVE
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2642
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Country | US
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Telephone | 228-623-2442
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Fax |
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Provider Business Mailing Address
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Address Line | 8105 DAP RD
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City | MOSS POINT
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State | MS
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Zip | 39562-5001
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Country | US
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Telephone | 228-623-2442
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | STEPHANIE DANIS
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Credential |
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Telephone | 228-623-2442
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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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