Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1003463787 |
---|---|
Provider Name | Mrs. Denise Ann Hill |
First Address | Fairburn, GA 30213-4328 |
Second Address | Fairburn, GA 30213-4328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |