Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFO03140 | VA |
NPI | 1720445364 |
---|---|
Provider Name | Mrs. Nicole Sibiga |
First Address | Virginia Beach, VA 23462-5701 |
Second Address | Virginia Beach, VA 23462-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2016 |
Last Update Date | 27/01/2016 |