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General NPI Number Information
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NPI Number | 1578415444
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Entity Type | Organization
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Legal Business Name | EASTERN CRANIAL AFFILIATES, LLC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 312 PROGRESS ST STE 300
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3356
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Country | US
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Telephone | 703-807-5899
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Fax | 703-807-1183
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Provider Business Mailing Address
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Address Line | 10523 MAIN ST STE 100
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City | FAIRFAX
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State | VA
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Zip | 22030-3310
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Country | US
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Telephone | 703-807-5899
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Fax | 703-807-1183
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Authorized Official
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Title or Position | PARTNER
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Name | MR. JOSEPH JAMES SMITH
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Credential | CPO
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Telephone | 703-807-5899
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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 |
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