Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFTS1748 | NC |
NPI | 1841690880 |
---|---|
Provider Name | Karen Banks |
First Address | New Bern, NC 28562-5218 |
Second Address | New Bern, NC 28562-5218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2014 |
Last Update Date | 27/08/2014 |