Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1508002569 |
---|---|
Provider Name | Mr. Jeffrey Scott Hooker |
First Address | Southern Pines, NC 28387-7052 |
Second Address | Southern Pines, NC 28387-7052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2008 |
Last Update Date | 26/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795451 | (05) | NC |
CFTS0569 | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS, AND PEDORTHICS, INC. (01) |