Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CPED0653 | MD |
NPI | 1669543245 |
---|---|
Provider Name | Lucy M Mohr |
First Address | Ocean Pines, MD 21811-1687 |
Second Address | Ocean Pines, MD 21811-1687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 06/01/2009 |