Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1093279838 |
---|---|
Provider Name | Latisha Barnes |
First Address | Durham, NC 27703-8410 |
Second Address | Durham, NC 27710-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2019 |
Last Update Date | 25/01/2019 |