Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C51961 | MD |
NPI | 1073907747 |
---|---|
Provider Name | James Curtis Davis |
First Address | Greenville, NC 27834-7268 |
Second Address | Greenville, NC 27834-7268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2015 |
Last Update Date | 23/03/2015 |