Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | L1358080 | MI |
NPI | 1477888618 |
---|---|
Provider Name | Mrs. Kathleen M Tooman |
First Address | Ludington, MI 49431 |
Second Address | Ludington, MI 49431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2009 |
Last Update Date | 06/10/2009 |