Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 511 | AL |
NPI | 1013323013 |
---|---|
Provider Name | Reginald Mays |
First Address | Bessemer, AL 35022-6029 |
Second Address | Bessemer, AL 35022-6029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2014 |
Last Update Date | 10/07/2014 |