Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C18040 | NC |
NPI | 1457556441 |
---|---|
Provider Name | Mrs. Donna Swanson Warmuth |
First Address | Hickory, NC 28603-3766 |
Second Address | Hickory, NC 28602-3401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7795117 | (05) | NC |
7795462 | (05) | NC |