Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | CPED3362 | DE |
N | 225000000X | Orthotic Fitter | CPED3362 | DE |
NPI | 1477820090 |
---|---|
Provider Name | Ms. Cherry Cooper Tull |
First Address | Winston Salem, NC 27103-1338 |
Second Address | Winston Salem, NC 27103-1338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2011 |
Last Update Date | 23/07/2013 |