Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | NC |
NPI | 1851934939 |
---|---|
Provider Name | Michele Louise Reams |
First Address | Raeford, NC 28376-3223 |
Second Address | Raeford, NC 28376-3223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2019 |
Last Update Date | 22/10/2019 |