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Dothan Brace Shop
Prosthetic/Orthotic Supplier in Dothan, Alabama
NPI 1730189028

Dothan Brace Shop is a Prosthetic/Orthotic Supplier based in Dothan, AL. Dothan Brace Shop practices in Dothan, AL. The NPI Number for Dothan Brace Shop is 1730189028 and holds a License No. 172 (Alabama).

The current practice location address for Dothan Brace Shop is 1240 E Main St, Dothan, AL and can be reached out via phone at 334-792-4330 and via fax at 334-794-6741.

Location: 1240 E Main St, Dothan, AL, 36301-1732
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730189028
Provider Name
Dothan Brace Shop
Credential
Provider Entity Type
Organization
Address
1240 E Main St, Dothan, AL, 36301-1732
Phone Number
334-792-4330
Fax Number
334-794-6741
Provider Enumeration Date
07/28/2005
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000040862B 01 GA MEDICAID
000040862A 05 GA
000050220 05 AL
51050220 01 BCBS
institution
Provider Business Practice Location Address Details
Address
1240 E Main St
City
Dothan
State
Alabama
Zip
36301-1732
Phone Number
334-792-4330
Fax Number
334-794-6741
person
Provider Business Mailing Address Details
Address
1240 E Main St
City
Dothan
State
Alabama
Zip
36301-1732
Phone Number
334-792-4330
Fax Number
334-794-6741
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
001 (Alabama)
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.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
172 (Alabama)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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