Provider Demographics
NPI:1003397829
Name:BIRMINGHAM BRACES
Entity Type:Organization
Organization Name:BIRMINGHAM BRACES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-956-4277
Mailing Address - Street 1:PO BOX 130224
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-0224
Mailing Address - Country:US
Mailing Address - Phone:205-296-3149
Mailing Address - Fax:
Practice Address - Street 1:2224 CAHABA VALLEY DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2668
Practice Address - Country:US
Practice Address - Phone:205-956-4277
Practice Address - Fax:205-991-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental