Provider Demographics
NPI:1023368180
Name:ACHIEVE BRACING
Entity Type:Organization
Organization Name:ACHIEVE BRACING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:MUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-534-0692
Mailing Address - Street 1:1732 N EASTMAN RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-2376
Mailing Address - Country:US
Mailing Address - Phone:423-765-1611
Mailing Address - Fax:423-765-1612
Practice Address - Street 1:1732 N EASTMAN RD STE 1A
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-2376
Practice Address - Country:US
Practice Address - Phone:423-765-1611
Practice Address - Fax:423-765-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier