Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1740672328 |
---|---|
Provider Name | Angeline Reiling |
First Address | Jacksonville, NC 28544-1418 |
Second Address | Jacksonville, NC 28546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2015 |
Last Update Date | 09/08/2018 |