Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | L21000519305 | FL |
NPI | 1982364816 |
---|---|
Provider Name | Michael Fraunfelter |
First Address | Royal Palm Beach, FL 33411-7636 |
Second Address | Royal Palm Beach, FL 33411-7636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2021 |
Last Update Date | 20/12/2021 |