Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1497939573 |
---|---|
Provider Name | Mr. David Rodney Marshall |
First Address | Fruit Cove, FL 32259-3175 |
Second Address | Fruit Cove, FL 32259-3175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2007 |
Last Update Date | 23/06/2008 |