Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C16838 (MAST FITTER) | NC |
NPI | 1700985595 |
---|---|
Provider Name | Joyce Thompson Ramos |
First Address | Fayetteville, NC 28304 |
Second Address | Fayetteville, NC 28304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 26/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795102 | (05) | NC |