Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DT-DO-10179741 | OR |
NPI | 1891214409 |
---|---|
Provider Name | Melanie Chapman |
First Address | Hood River, OR 97031-1538 |
Second Address | Hood River, OR 97031-1538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2017 |
Last Update Date | 17/03/2018 |