Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1316165483 |
---|---|
Provider Name | Mrs. Beverly Jo Meissner |
First Address | Milton, WA 98354-8921 |
Second Address | Auburn, WA 98002-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |