Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | NONE REQUIRED | MI |
NPI | 1083644686 |
---|---|
Provider Name | Mrs. Sharon L Tabor |
First Address | Marquette, MI 49855-2675 |
Second Address | Marquette, MI 49855-2675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 17/03/2009 |