Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | C17052 | NC |
NPI | 1629199906 |
---|---|
Provider Name | Gregory C Federico |
First Address | Cary, NC 27511-7406 |
Second Address | Cary, NC 27511-7406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |