Back Brace Supply LLC

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Legal business name

BACK BRACE SUPPLY LLC

Practice address

670 S White Station Rd
Memphis, TN 38117-4527

Phone

(901) 619-2297

NPI assigned

Oct 1, 2019

Last updated

Nov 5, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dana Hunter Paschal

Title

Owner

Phone

(901) 619-2297

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1225679277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 S WHITE STATION RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174527",
            "telephone_number": "901-619-2297",
            "fax_number": "901-763-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 S WHITE STATION RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174527",
            "telephone_number": "901-619-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK BRACE SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "PASCHAL",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-619-2297"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Patricia W Bader, NP
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• Kelly Marie Badura, PA

• Orthotic Fitter in Memphis, TN
• Providers in Memphis, TN by specialty
• Orthotic Fitter in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.