Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | CFOM0204 | NC |
NPI | 1023073517 |
---|---|
Provider Name | Mrs. Sylvia S Meads |
First Address | Eliz City, NC 27909 |
Second Address | Eliz City, NC 27909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 01/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0482P | BCBS (01) | NC |
384410 | BCBS (01) | VA |
7701327 | (05) | NC |
7795160 | INDIVID EDS (01) | |
9190511 | (05) | VA |