Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFTS1147 | NC |
NPI | 1235411521 |
---|---|
Provider Name | Mrs. Angela P Bryant |
First Address | Lumberton, NC 28360-0563 |
Second Address | Pembroke, NC 28372-8768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 19/09/2011 |