Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFTS0721 | NC |
NPI | 1215176037 |
---|---|
Provider Name | Stephanie Eason Greene |
First Address | Cherryville, NC 28021-2812 |
Second Address | Cherryville, NC 28021-2812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 18/02/2009 |