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Organization
MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC
Active
Organization
MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCILLE FORMEISTER (DIR. BUS SYSTEMS)
(860) 667-9542
Entity
Organization
Contact information
Practice address
1760 OLD MEADOW RD, MC LEAN, VA 22102-4331
(860) 667-9542
Mailing address
1760 OLD MEADOW RD, MC LEAN, VA 22102-4331
(860) 667-9542
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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