Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1760786271 |
---|---|
Provider Name | Patrick Ifeanyi Obiora Ogbonna |
First Address | Raleigh, NC 27609-6286 |
Second Address | Raleigh, NC 27609-6286 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2010 |
Last Update Date | 28/12/2010 |