Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1548493596 |
---|---|
Provider Name | Lisa M Luna |
First Address | Garland, TX 75043-5728 |
Second Address | Garland, TX 75043-5728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2009 |
Last Update Date | 25/08/2009 |