Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | OF000008 | PA |
NPI | 1013304930 |
---|---|
Provider Name | Ellen Marie Betley |
First Address | Norristown, PA 19401-1333 |
Second Address | Norristown, PA 19401-1333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 18/04/2015 |