Provider Demographics
NPI:1134468770
Name:BRACING & REHAB KINETICS LLC
Entity Type:Organization
Organization Name:BRACING & REHAB KINETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESTEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:865-809-1781
Mailing Address - Street 1:PO BOX 23590
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-1590
Mailing Address - Country:US
Mailing Address - Phone:865-365-3170
Mailing Address - Fax:865-365-3171
Practice Address - Street 1:1105 FOXWOOD DR.
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5029
Practice Address - Country:US
Practice Address - Phone:865-365-3160
Practice Address - Fax:865-365-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001404332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment