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General NPI Number Information
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NPI Number | 1144300161
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER ORTHOTICS AND PROSTHETICS LLC
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 2421 LINDEN LANE
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City | SILVER SPRING
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State | MD
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Zip | 20910-1230
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Country | US
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Telephone | 301-585-5347
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Fax | 301-585-4383
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Provider Business Mailing Address
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Address Line | 2421 LINDEN LN
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City | SILVER SPRING
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State | MD
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Zip | 20910-1230
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Country | US
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Telephone | 301-585-5347
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Fax | 301-585-4383
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Authorized Official
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Title or Position | DIRECTOR, TREASURER
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Name | BRADFORD GARDNER
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Credential |
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Telephone | 615-864-8783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | MD
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