Provider Demographics
NPI:1518913425
Name:ORTHOTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ORTHOTIC SOLUTIONS, LLC
Other - Org Name:ORTHOTIC SOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:STIKELEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:703-849-9200
Mailing Address - Street 1:5130 DUKE ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2924
Mailing Address - Country:US
Mailing Address - Phone:703-751-5138
Mailing Address - Fax:
Practice Address - Street 1:5130 DUKE ST
Practice Address - Street 2:SUITE 14
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2924
Practice Address - Country:US
Practice Address - Phone:703-751-5138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty