Organization
OLD DOMINION PROSTHETICS & ORTHOTICS, INC.
Active
Parent organization
OLD DOMINION PROSTHETICS & ORTHOTICS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLD DOMINION PROSTHETICS & ORTHOTICS, INC.
Authorized official
MRS. CATHERINE GARRISON (MANAGER)
(434) 973-6209
Entity
Organization
Contact information
Practice address
612 RIO RD W, CHARLOTTESVILLE, VA 22901-1412
(434) 973-6209
(434) 973-1774
Mailing address
612 RIO RD W, CHARLOTTESVILLE, VA 22901-1412
(434) 973-6209
(434) 973-1774
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106977
ANTHEM
VA
Enumeration date
12/11/2007
Last updated
12/11/2007
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