Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 01948 | NC |
NPI | 1316114523 |
---|---|
Provider Name | Mrs. Kimberly Carol Wheeler |
First Address | Pinehurst, NC 28374-9797 |
Second Address | Pinehurst, NC 28374-9797 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 15/05/2008 |