Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1235482704 |
---|---|
Provider Name | Christopher Davis |
First Address | Seattle, WA 98122-5371 |
Second Address | Seattle, WA 98122-5371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2012 |
Last Update Date | 22/10/2012 |