Provider Demographics
NPI:1285064113
Name:PERFORMANCE BRACING LLC
Entity type:Organization
Organization Name:PERFORMANCE BRACING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-907-5333
Mailing Address - Street 1:2914 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2516
Mailing Address - Country:US
Mailing Address - Phone:205-907-5333
Mailing Address - Fax:205-423-0910
Practice Address - Street 1:2914 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2516
Practice Address - Country:US
Practice Address - Phone:205-907-5333
Practice Address - Fax:205-423-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies