Organization
POTOMAC COBBLER, INC
Active
Organization
POTOMAC COBBLER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MARTIN BROWN SR. BOARD CERTIFIED PEDO (SEC/TREAS. POTOMAC COBBER, INC)
(703) 491-4222
Entity
Organization
Contact information
Practice address
14437 JEFFERSON DAVIS HIGHWAY, WOODBRIDGE, VA 22191-2805
(703) 491-4222
(703) 491-1040
Mailing address
14437 JEFFERSON DAVIS HIGHWAY, WOODBRIDGE, VA 22191-2805
(703) 491-4222
(703) 491-1040
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1994
VA
Other
Enumeration date
11/26/2008
Last updated
11/26/2008
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