Provider Demographics
NPI:1013263813
Name:ADVANCED BRACING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ADVANCED BRACING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-363-0500
Mailing Address - Street 1:3224 DIJON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-8520
Mailing Address - Country:US
Mailing Address - Phone:228-363-0500
Mailing Address - Fax:228-207-0526
Practice Address - Street 1:3224 DIJON AVE
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-8520
Practice Address - Country:US
Practice Address - Phone:228-363-0500
Practice Address - Fax:228-207-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies