Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1689683732 |
---|---|
Provider Name | Ms. Peggy A Wendt |
First Address | Neenah, WI 54956-4825 |
Second Address | Neenah, WI 54956-4825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 28/08/2007 |