Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1982842068 |
---|---|
Provider Name | Mrs. Robin Padgett |
First Address | Greensboro, NC 27405-3382 |
Second Address | Gastonia, NC 28054-0649 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2009 |
Last Update Date | 21/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C20133 | BOARD FOR ORTHOTIST/PROSTHETIST CERTIFICATION (01) | NC |
CFM01553 | AMERICAN BOARD FOR CERTIFICATION (01) | NC |