Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFOM0108 | CA |
NPI | 1558572123 |
---|---|
Provider Name | Ms. Gerri Ann Hamilton |
First Address | Concord, CA 94520-5789 |
Second Address | Concord, CA 94520-5789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |