Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | 013968 | CT |
NPI | 1881888493 |
---|---|
Provider Name | Ms. Lucinda Beaty |
First Address | Cheshire, CT 06410-2207 |
Second Address | Cheshire, CT 06410-2207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 30/08/2007 |