Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1588938005 |
---|---|
Provider Name | Susan Elaine Cotton |
First Address | Santa Rosa, CA 95409-4240 |
Second Address | Santa Rosa, CA 95409-4240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2012 |
Last Update Date | 01/03/2012 |