Provider Demographics
NPI:1811447386
Name:ORTHOFIT BRACING
Entity type:Organization
Organization Name:ORTHOFIT BRACING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUITRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-707-0573
Mailing Address - Street 1:1818 N TAYLOR ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4639
Mailing Address - Country:US
Mailing Address - Phone:501-707-0573
Mailing Address - Fax:501-764-4171
Practice Address - Street 1:1818 N TAYLOR ST STE 150
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4639
Practice Address - Country:US
Practice Address - Phone:501-707-0573
Practice Address - Fax:501-764-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies