Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1609457423 |
---|---|
Provider Name | Adam Guinn |
First Address | Norris, TN 37828-0950 |
Second Address | Norris, TN 37828-3033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2021 |
Last Update Date | 15/04/2021 |