Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFO04865 | NC |
NPI | 1700435484 |
---|---|
Provider Name | Mr. Jeremy Joseph Hooker |
First Address | Asheville, NC 28801-4608 |
Second Address | Asheville, NC 28801-4608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2019 |
Last Update Date | 05/09/2019 |