Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1730231630 |
---|---|
Provider Name | Mr. Stephen Joseph Taubner |
First Address | Mount Vernon, ME 04352-3823 |
Second Address | Mount Vernon, ME 04352-3823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |