Organization
ONE STEP ORTHOTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYIS PATATANIAN (OWNER)
(703) 858-5373
Entity
Organization
Contact information
Practice address
21785 FILIGREE CT, #211, ASHBURN, VA 20147-6213
(703) 858-5373
(703) 858-5374
Mailing address
21785 FILIGREE CT, #211, ASHBURN, VA 20147-6213
(703) 858-5373
(703) 858-5374
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
B602611
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010188024
—
VA
01
—
188613
ANTHEM
VA
Enumeration date
10/24/2006
Last updated
02/14/2011
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