Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFOM0702 | CA |
NPI | 1447652417 |
---|---|
Provider Name | Melissa Maria Garcia |
First Address | Bakersfield, CA 93301-4002 |
Second Address | Bakersfield, CA 93301-4002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 22/09/2014 |