Organization
EASTERN CRANIAL AFFILIATES, LLC
Active
Other names
Infinite Technologies Orthotics & Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH FRANK TERPENNING C.O., FAAOP (OWNER)
(703) 807-5899
Entity
Organization
Contact information
Practice address
10523 MAIN ST, FAIRFAX, VA 22030
(703) 807-5899
(703) 807-1183
Mailing address
10523 MAIN ST, FAIRFAX, VA 22030
(703) 807-5899
(703) 807-1183
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009190121
—
VA
01
—
288615
ANTHEM
VA
01
—
H933
BCBS
VA
Enumeration date
10/10/2006
Last updated
11/18/2014
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