Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | 21 | OK |
NPI | 1881696177 |
---|---|
Provider Name | Anthony W Layton |
First Address | Lawton, OK 73501-4006 |
Second Address | Lawton, OK 73501-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 20/11/2007 |