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Individual

LUKE STIKELEATHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.O.

Contact information

Practice address
3023 HAMAKER CT, SUITE LL-50, FAIRFAX, VA 22031-2207
(703) 849-8808
Mailing address
3023 HAMAKER CT, SUITE LL-50, FAIRFAX, VA 22031-2207

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO001885
ORTHOTIST CERTIFICATE
Enumeration date
02/03/2016
Last updated
03/17/2018
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