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General NPI Number Information
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NPI Number | 1982671640
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Entity Type | Organization
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Legal Business Name | ACCESS ABILITY ORTHOTICS, LLC
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 14300 CHERRY LANE CT SUITE 213
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City | LAUREL
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State | MD
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Zip | 20707-4958
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Country | US
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Telephone | 301-776-5200
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Fax | 301-776-4480
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Provider Business Mailing Address
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Address Line | 14300 CHERRY LANE CT SUITE 213
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City | LAUREL
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State | MD
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Zip | 20707-4958
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Country | US
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Telephone | 301-776-5200
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Fax | 301-776-4480
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID RANDY HARRIS
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Credential | C.O.
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Telephone | 301-776-5200
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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 | CO001692
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License Number State | MD
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