Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1851385728 |
---|---|
Provider Name | Christopher Pete Guinn |
First Address | Austin, TX 78758-2428 |
Second Address | Austin, TX 78758-2428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171115202 | (05) | TX |
171115204 | (05) | TX |