Provider Demographics
NPI:1649778382
Name:BOSTON BRACE INTERNATIONAL INC.
Entity Type:Organization
Organization Name:BOSTON BRACE INTERNATIONAL INC.
Other - Org Name:BOSTON ORTHOTICS & PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-638-1170
Mailing Address - Street 1:20 LEDIN DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:MA
Mailing Address - Zip Code:02322-1156
Mailing Address - Country:US
Mailing Address - Phone:508-588-6060
Mailing Address - Fax:
Practice Address - Street 1:3738 CHOUTEAU AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2508
Practice Address - Country:US
Practice Address - Phone:314-474-1900
Practice Address - Fax:314-448-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier