Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | NC | |
N | 225000000X | Orthotic Fitter | NC |
NPI | 1598158289 |
---|---|
Provider Name | Mrs. Melissa Ferguson Giles |
First Address | Winston Salem, NC 27103-1418 |
Second Address | Winston Salem, NC 27103-1418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2015 |
Last Update Date | 25/03/2015 |