Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | ORF119 | FL |
NPI | 1023444361 |
---|---|
Provider Name | Mr. Jay J Rhodes |
First Address | Cape Coral, FL 33914-6321 |
Second Address | Cape Coral, FL 33904-7515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2013 |
Last Update Date | 16/12/2013 |