NPI 1063667434

Potomac Cobbler, INC

Organisation Prosthetic/Orthotic Supplier Woodbridge, VA

Practice location

Address: 14437 Jefferson Davis Highway, Woodbridge, VA 22191-2805
Phone: (703) 491-4222
Fax: (703) 491-1040

Authorised official

Name: James Martin Brown
Title: Sec/Treas. Potomac Cobber, INC
Phone: (703) 491-4222

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 1994 (VA)

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Registry record

NPI: 1063667434
Entity type: Organization
NPI issued: 26 Nov 2008
Record last updated: 26 Nov 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.