Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1013458827 |
---|---|
Provider Name | Deborah Parra |
First Address | Schaumburg, IL 60193-2764 |
Second Address | Lansing, IL 60438-3379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2017 |
Last Update Date | 22/12/2021 |