Organization
MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCILLE FORMEISTER (DIR. BUS SYSTEMS)
(860) 667-9542
Entity
Organization
Contact information
Practice address
1760 OLD MEADOW RD, MC LEAN, VA 22102-4331
(860) 667-9542
Mailing address
1760 OLD MEADOW RD, MC LEAN, VA 22102-4331
(860) 667-9542
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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