Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1538489745 |
---|---|
Provider Name | Mrs. Laura Bullinger |
First Address | Middletown, NY 10940-2302 |
Second Address | Middletown, NY 10940-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2010 |
Last Update Date | 10/06/2010 |