Organization
MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE CORCORAN (CEO)
(301) 585-5347
Entity
Organization
Contact information
Practice address
6060 PIEDMONT ROW DR S STE 320, CHARLOTTE, NC 28287-3884
(301) 585-5347
Mailing address
2409 LINDEN LN, SILVER SPRING, MD 20910-1230
(301) 585-5347
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118294
—
NC
Enumeration date
07/29/2021
Last updated
03/12/2024
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