Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | AL |
NPI | 1407417702 |
---|---|
Provider Name | Mrs. Sasha J White |
First Address | Huntsville, AL 35801 |
Second Address | Huntsville, AL 35801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 26/06/2019 |