Healthcare Provider Details

I. General information

NPI: 1902697790
Provider Name (Legal Business Name): SPECIALIZED ORTHOPAEDIC SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 BACKLICK RD STE D
SPRINGFIELD VA
22150-2230
US

IV. Provider business mailing address

307 MAPLE AVE W STE F
VIENNA VA
22180-4307
US

V. Phone/Fax

Practice location:
  • Phone: 703-281-1200
  • Fax: 703-281-1201
Mailing address:
  • Phone: 703-405-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN RICHARD KURELICH
Title or Position: PRESIDENT
Credential:
Phone: 703-281-1200