institution
Custom Brace Shop Inc.
Durable Medical Equipment & Medical Supplies in Galesburg, Illinois
NPI 1306865563

Custom Brace Shop Inc. is a Durable Medical Equipment & Medical Supplies based in Galesburg, IL. Custom Brace Shop Inc. practices in Galesburg, IL. The NPI Number for Custom Brace Shop Inc. is 1306865563 and holds a License No. (Illinois).

The current practice location address for Custom Brace Shop Inc. is 872 W Dayton St, Galesburg, IL and can be reached out via phone at 309-344-5330 and via fax at 309-344-5040.

Location: 872 W Dayton St, Galesburg, IL, 61401-1503
institution
Provider Profile Details
NPI Number
1306865563
Provider Name
Custom Brace Shop Inc.
Credential
Provider Entity Type
Organization
Address
872 W Dayton St, Galesburg, IL, 61401-1503
Phone Number
309-344-5330
Fax Number
309-344-5040
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30404878 01 IL CERTIFICATE OF REGISTRATI
institution
Provider Business Practice Location Address Details
Address
872 W Dayton St
City
State
Zip
61401-1503
Phone Number
309-344-5330
Fax Number
309-344-5040
person
Provider Business Mailing Address Details
Address
872 W Dayton St
City
State
Zip
61401-1503
Phone Number
309-344-5330
Fax Number
309-344-5040
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
License No.
()
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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