Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFM00776 | CA |
NPI | 1609011196 |
---|---|
Provider Name | Cindy Thomas |
First Address | Oakdale, CA 95361-9113 |
Second Address | Modesto, CA 95355-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2008 |
Last Update Date | 11/12/2008 |