Organization
DISTRICT AMPUTEE CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHRISTIAN FENTON (OWNER OPERATOR)
(202) 338-0770
Entity
Organization
Contact information
Practice address
730 24TH ST NW STE 11, WASHINGTON, DC 20037-2591
(202) 338-0770
(202) 315-3176
Mailing address
730 24TH ST NW STE 11, WASHINGTON, DC 20037-2591
(202) 338-0770
(202) 315-3176
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042760100
—
DC
01
—
1030109
ACM
—
01
—
4417
CAREFIRST
—
Enumeration date
03/12/2014
Last updated
12/21/2022
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