Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1497825780 |
---|---|
Provider Name | Brian Fredrick Karsten |
First Address | Grand Junction, CO 81505-1279 |
Second Address | Grand Junction, CO 81505-1279 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 04/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08001679 | (05) | CO |