Provider Demographics
NPI:1639760069
Name:MBRACE HAND THERAPY LLC
Entity Type:Organization
Organization Name:MBRACE HAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-317-4367
Mailing Address - Street 1:PO BOX 47413
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85068-7413
Mailing Address - Country:US
Mailing Address - Phone:602-641-4263
Mailing Address - Fax:
Practice Address - Street 1:4643 N 12TH ST STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4083
Practice Address - Country:US
Practice Address - Phone:602-641-4263
Practice Address - Fax:602-641-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment