Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1114485968 |
---|---|
Provider Name | Julia Maurie Ford |
First Address | Reynoldsburg, OH 43068-3963 |
Second Address | Whitehall, OH 43213-1827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2019 |
Last Update Date | 03/02/2020 |