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General NPI Number Information
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NPI Number | 1891878567
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Entity Type | Organization
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Legal Business Name | ONE STEP ORTHOTIC LABORATORY LLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 21785 FILIGREE CT #211
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City | ASHBURN
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State | VA
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Zip | 20147-6213
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Country | US
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Telephone | 703-858-5373
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Fax | 703-858-5374
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Provider Business Mailing Address
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Address Line | 21785 FILIGREE CT #211
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City | ASHBURN
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State | VA
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Zip | 20147-6213
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Country | US
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Telephone | 703-858-5373
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Fax | 703-858-5374
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Authorized Official
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Title or Position | OWNER
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Name | MAYIS PATATANIAN
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Credential |
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Telephone | 703-858-5373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | B602611
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License Number State | VA
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