Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1164627220 |
---|---|
Provider Name | Mrs. Jennifer R Pratt |
First Address | Oak Hill, VA 20171-2950 |
Second Address | Alexandria, VA 22304-7206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 08/07/2007 |