Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1407455595 |
---|---|
Provider Name | Maree Antonette Newby-Sanders |
First Address | Newport News, VA 23605-1044 |
Second Address | Newport News, VA 23605-1044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2020 |
Last Update Date | 20/10/2020 |