Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | MI |
NPI | 1346293180 |
---|---|
Provider Name | Mrs. Terry L Henley-Vogt |
First Address | Livonia, MI 48150-2416 |
Second Address | Livonia, MI 48150-2416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |