Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | OT711 | CA |
NPI | 1043355894 |
---|---|
Provider Name | Kathryn Marie Warner |
First Address | Los Angeles, CA 90068-3650 |
Second Address | Santa Monica, CA 90404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |