Provider Demographics
NPI:1669850137
Name:BRACING SPECIALISTS LLC
Entity Type:Organization
Organization Name:BRACING SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-810-1299
Mailing Address - Street 1:250 E WISCONSIN AVE
Mailing Address - Street 2:STE 1800
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4232
Mailing Address - Country:US
Mailing Address - Phone:414-810-1299
Mailing Address - Fax:
Practice Address - Street 1:250 E WISCONSIN AVE
Practice Address - Street 2:STE 1800
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4232
Practice Address - Country:US
Practice Address - Phone:414-810-1299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment