Provider Demographics
NPI:1578743639
Name:LAWTON BRACE & LIMB CO INC
Entity Type:Organization
Organization Name:LAWTON BRACE & LIMB CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY-TREASURER/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO LPO
Authorized Official - Phone:580-353-5525
Mailing Address - Street 1:2724 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6319
Mailing Address - Country:US
Mailing Address - Phone:580-353-5525
Mailing Address - Fax:580-353-5523
Practice Address - Street 1:2724 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6319
Practice Address - Country:US
Practice Address - Phone:580-353-5525
Practice Address - Fax:580-353-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPO46335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0611790001Medicare NSC