Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C46877 | NC |
NPI | 1902137995 |
---|---|
Provider Name | Stacee Christine Thornton |
First Address | Durham, NC 27704-2197 |
Second Address | Durham, NC 27704-2197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 29/01/2010 |