Provider Demographics
NPI:1851397681
Name:WRIGHT BRACE AND LIMB INC
Entity Type:Organization
Organization Name:WRIGHT BRACE AND LIMB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CERTIFIED PRACTIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:989-343-0300
Mailing Address - Street 1:611 COURT ST
Mailing Address - Street 2:STE 102
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9390
Mailing Address - Country:US
Mailing Address - Phone:989-343-0300
Mailing Address - Fax:989-343-9771
Practice Address - Street 1:611 COURT ST
Practice Address - Street 2:STE 102
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9390
Practice Address - Country:US
Practice Address - Phone:989-343-0300
Practice Address - Fax:989-343-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4585166Medicaid
MI4885970001Medicare NSC