Provider Demographics
NPI:1760009179
Name:BRACES AND ORTHOTICS, LLC
Entity Type:Organization
Organization Name:BRACES AND ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-201-7993
Mailing Address - Street 1:331 WALKER DR STE 6
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-4374
Mailing Address - Country:US
Mailing Address - Phone:571-786-2671
Mailing Address - Fax:
Practice Address - Street 1:331 WALKER DR STE 6
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-4374
Practice Address - Country:US
Practice Address - Phone:571-786-2671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies