Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1134713100 |
---|---|
Provider Name | Remona Laing |
First Address | Davenport, IA 52803-4674 |
Second Address | Davenport, IA 52803-4674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2021 |
Last Update Date | 21/02/2021 |