Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1235719733 |
---|---|
Provider Name | Marilyn Leah Keeler |
First Address | Raeford, NC 28376-3223 |
Second Address | Raeford, NC 28376-3223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2021 |
Last Update Date | 09/04/2021 |