Organization
ORTHOTIC PROSTHETIC CENTER, INC.
Active
Organization
ORTHOTIC PROSTHETIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CORCORAN CPO (CEO)
(301) 906-0603
Entity
Organization
Contact information
Practice address
224 CORNWALL ST NW, CORNWALL PAVILION BUILDING 224-D SUITE 200B, LEESBURG, VA 20176-2701
(571) 291-3121
Mailing address
8330 PROFESSIONAL HILL DR, FAIRFAX, VA 22031-4611
(703) 698-5007
(703) 207-9395
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/21/2014
Last updated
02/13/2020
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