Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1962417253 |
---|---|
Provider Name | Linda D Busch |
First Address | Lapwai, ID 83540-0367 |
Second Address | Lapwai, ID 83540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 04/03/2010 |