Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1033595707 |
---|---|
Provider Name | Mark R Chapman JR. |
First Address | Matthews, NC 28105-5057 |
Second Address | Matthews, NC 28105-5057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2015 |
Last Update Date | 05/08/2015 |