Provider Demographics
NPI:1568132520
Name:ONE STOP BRACING
Entity Type:Organization
Organization Name:ONE STOP BRACING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:EBHOHIMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-491-2668
Mailing Address - Street 1:3432 HIGHWAY 155
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-3741
Mailing Address - Country:US
Mailing Address - Phone:470-491-2668
Mailing Address - Fax:789-497-3631
Practice Address - Street 1:3432 HIGHWAY 155
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3741
Practice Address - Country:US
Practice Address - Phone:470-491-2668
Practice Address - Fax:789-497-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies