Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1558767814 |
---|---|
Provider Name | Michele Renee Savage |
First Address | Cottage Grove, OR 97424 |
Second Address | Cottage Grove, OR 97424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2014 |
Last Update Date | 14/11/2014 |