Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 276 | TX |
NPI | 1447211735 |
---|---|
Provider Name | Susan Leonore Kapp |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 05/12/2007 |