Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C50396 | NC |
NPI | 1649545179 |
---|---|
Provider Name | Melissa A Fouts |
First Address | Franklin, NC 28734-3204 |
Second Address | Franklin, NC 28734-3204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2012 |
Last Update Date | 16/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C50396 | CERTIFIED ORTHOTIC FITTER (01) | NC |