Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner |
NPI | 1669489423 |
---|---|
Provider Name | Mr. Phillip D Pugh |
First Address | Durham, NC 27704-6037 |
Second Address | Durham, NC 27705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |