Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist |
NPI | 1316607799 |
---|---|
Provider Name | Mrs. Tonya R Porter-Pitts |
First Address | Rocky Mount, NC 27801-3532 |
Second Address | Rocky Mount, NC 27804-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2021 |
Last Update Date | 27/12/2021 |