Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | C20051 | MD |
NPI | 1831497510 |
---|---|
Provider Name | Ms. Steffy Jeanne Trousdale |
First Address | Cypress, CA 90630 |
Second Address | Long Beach, CA 90807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2011 |
Last Update Date | 10/03/2011 |