Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1164686390 |
---|---|
Provider Name | Mandi J Sedlak |
First Address | Kearney, NE 68845-1280 |
Second Address | Kearney, NE 68845-1280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 16/07/2008 |