Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CT178219 | PA |
NPI | 1104470863 |
---|---|
Provider Name | Ms. Anntoinette Hobbs |
First Address | Mechanicsburg, PA 17050-7990 |
Second Address | Mechanicsburg, PA 17055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2019 |
Last Update Date | 13/10/2020 |