Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFO05254 | NC |
NPI | 1073107306 |
---|---|
Provider Name | Julie Bain Windham |
First Address | Fayetteville, NC 28304-7067 |
Second Address | Fayetteville, NC 28304-3414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |