Provider Demographics
NPI:1043491848
Name:WHEELCHAIR BIOMECHANIX
Entity type:Organization
Organization Name:WHEELCHAIR BIOMECHANIX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRUNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-556-8256
Mailing Address - Street 1:PO BOX 1918
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31799-1918
Mailing Address - Country:US
Mailing Address - Phone:850-556-8256
Mailing Address - Fax:
Practice Address - Street 1:1209 E JACKSON STREET
Practice Address - Street 2:SUITE A
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792
Practice Address - Country:US
Practice Address - Phone:850-556-8256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies