Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1487845319 |
---|---|
Provider Name | Mr. Michael Joseph Bright |
First Address | Fairfield, CA 94534-9651 |
Second Address | Fairfield, CA 94534-9651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 09/10/2012 |