Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1063084036 |
---|---|
Provider Name | Elizabeth Brown |
First Address | Emporia, VA 23847-2517 |
Second Address | Chester, VA 23836-8606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2021 |
Last Update Date | 10/07/2021 |