Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1053943381 |
---|---|
Provider Name | Ashley K Sorrell |
First Address | Fuquay Varina, NC 27526-4936 |
Second Address | Fuquay Varina, NC 27526-4936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2020 |
Last Update Date | 05/02/2020 |