Provider Demographics
NPI:1386090819
Name:CHOICE PROSTHETICS AND ORTHOTICS, LLC
Entity type:Organization
Organization Name:CHOICE PROSTHETICS AND ORTHOTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:240-401-8063
Mailing Address - Street 1:2445 ARMY NAVY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2988
Mailing Address - Country:US
Mailing Address - Phone:667-210-2149
Mailing Address - Fax:667-210-2167
Practice Address - Street 1:2445 ARMY NAVY DR STE 301
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2988
Practice Address - Country:US
Practice Address - Phone:667-210-2149
Practice Address - Fax:667-210-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier