Oritsematosan Ayu
Technician, Other in Springfield, VA. Individual provider (NPI-1).
NPI number1174970347
StatusActive
Last updated in NPPESMay 18, 2016
Details
- NPI
- 1174970347
- Entity type
- Individual (NPI-1)
- Name
- Oritsematosan Ayu
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 18, 2016
- Last updated
- May 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | 0230027933 | VA | Yes |
Practice location
6501 Loisdale CtSpringfield, VA 22150-1826
Phone 703-922-1530
Mailing address
6501 Loisdale CtSpringfield, VA 22150-1826
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