Provider Demographics
NPI:1255642542
Name:HUTTO LIMB AND BRACE, LLC
Entity type:Organization
Organization Name:HUTTO LIMB AND BRACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:HUTTO
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPO/LPO
Authorized Official - Phone:706-507-4254
Mailing Address - Street 1:1538 13TH AVE
Mailing Address - Street 2:BUILDING B-200
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1956
Mailing Address - Country:US
Mailing Address - Phone:706-507-4254
Mailing Address - Fax:706-507-4256
Practice Address - Street 1:1538 13TH AVE
Practice Address - Street 2:BUILDING B-200
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1956
Practice Address - Country:US
Practice Address - Phone:706-507-4254
Practice Address - Fax:706-507-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA0000018335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier