Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | C52236 | AR |
NPI | 1932636248 |
---|---|
Provider Name | Marcus Day |
First Address | Rogers, AR 72758-8107 |
Second Address | Springdale, AR 72764-2609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 17/03/2018 |