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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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