Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1386817336 |
---|---|
Provider Name | Kerr Scott Wheatley |
First Address | Charlotte, NC 28211-1066 |
Second Address | Charlotte, NC 28211-1066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2008 |
Last Update Date | 10/04/2008 |