Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C50591 | NC |
NPI | 1710251517 |
---|---|
Provider Name | Mr. John F Bachman |
First Address | Clemmons, NC 27012-9396 |
Second Address | Clemmons, NC 27012-9396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2012 |
Last Update Date | 20/03/2013 |