Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C50607 | NC |
NPI | 1184980807 |
---|---|
Provider Name | Sasha Bobbitt |
First Address | Mocksville, NC 27028-9301 |
Second Address | Mocksville, NC 27028-9301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 06/04/2012 |