Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CPED2960 | MD |
NPI | 1336385863 |
---|---|
Provider Name | Kyle Austin Krabill |
First Address | Pocomoke City, MD 21851-2307 |
Second Address | Pittsville, MD 21850-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2009 |
Last Update Date | 06/01/2009 |