Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1790932267 |
---|---|
Provider Name | Ms. Latonia S. Mcmillian |
First Address | Laurinburg, NC 28352-5510 |
Second Address | Laurinburg, NC 28352-5510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 26/08/2008 |