Provider Demographics
NPI:1316004971
Name:COMPREHENSIVE BRACE AND LIMB CENTER
Entity type:Organization
Organization Name:COMPREHENSIVE BRACE AND LIMB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-337-8333
Mailing Address - Street 1:PO BOX 1211
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-8211
Mailing Address - Country:US
Mailing Address - Phone:330-337-8333
Mailing Address - Fax:330-337-8373
Practice Address - Street 1:2235 E PERSHING ST
Practice Address - Street 2:SUITE F
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-3478
Practice Address - Country:US
Practice Address - Phone:330-337-8333
Practice Address - Fax:330-337-8373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPO91332B00000X
OHLPO091335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2605256Medicaid
OH2605256Medicaid
OH=========OtherEIN