Idaho Sports Bracing Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IDAHO SPORTS BRACING INC

Practice address

711 N Ralstin St
Meridian, ID 83642-4079

Phone

(208) 887-9071

Fax

(208) 887-9235

NPI assigned

Jun 19, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Dannette M Peterson

Title

Secretary Treasurer

Phone

(208) 887-9071

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1801023643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836800625",
            "telephone_number": "208-887-9071",
            "fax_number": "208-887-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N RALSTIN ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424079",
            "telephone_number": "208-887-9071",
            "fax_number": "208-887-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO SPORTS BRACING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DANNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "208-887-9071",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Physical Medicine and Rehabilitation PA
• Idaho Physical Medicine and Rehabilitation PA
• Idaho Sleep and Wellness LLC
• Idaho Spine & Pain PLLC
• Idaho Spine and Sports Physical Therapy - Silverstone
• Idaho State University
• Idaho State University
• Idaho State University
• Idaho State University
• Idaho State University

• Durable Medical Equipment & Medical Supplies in Meridian, ID
• Providers in Meridian, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.