Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C18651 |
NPI | 1053563742 |
---|---|
Provider Name | Leah M Byrd |
First Address | Lumberton, NC 28358-3926 |
Second Address | Lumberton, NC 28358-3926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2008 |
Last Update Date | 01/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795474 | (05) | NC |