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General NPI Number Information
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NPI Number | 1245398072
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Entity Type | Organization
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Legal Business Name | ORTHO-GAIT INC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 14100 PARKE LONG CT SUITE A
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City | CHANTILLY
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State | VA
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Zip | 20151-1644
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Country | US
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Telephone | 703-263-1325
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Fax | 703-263-1805
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Provider Business Mailing Address
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Address Line | 14100 PARKE LONG CT SUITE A
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City | CHANTILLY
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State | VA
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Zip | 20151-1644
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Country | US
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Telephone | 703-263-1325
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Fax | 703-263-1805
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | SCOTT MOFFETT
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Credential |
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Telephone | 703-263-1325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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