Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1093863839 |
---|---|
Provider Name | Mr. Frank Loverso |
First Address | Sanford, NC 27330-4151 |
Second Address | Sanford, NC 27330-4151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 13/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0414L | BCBS (01) | NC |
7702039 | (05) | NC |
7704336 | (05) | NC |
7795074 | (05) | NC |