Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1316211238 |
---|---|
Provider Name | Mr. Ahmahn M Peeples |
First Address | Rio Rancho, NM 87124-4791 |
Second Address | Rio Rancho, NM 87124-4791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2012 |
Last Update Date | 23/11/2015 |