Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C16055 | MD |
NPI | 1346886496 |
---|---|
Provider Name | James Edward Newton |
First Address | Rock Hill, SC 29732-1089 |
Second Address | Rock Hill, SC 29732-1089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2019 |
Last Update Date | 25/11/2019 |