Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | 2925 |
NPI | 1245547843 |
---|---|
Provider Name | Mr. Kenneth A Zelin |
First Address | Charlotte, NC 28277-3884 |
Second Address | Charlotte, NC 28277-3884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2010 |
Last Update Date | 03/09/2010 |