Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFO04457 | NC |
NPI | 1700389657 |
---|---|
Provider Name | Taylor Kathryn Raines |
First Address | Pinehurst, NC 28374-0088 |
Second Address | Pinehurst, NC 28374-0088 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2018 |
Last Update Date | 16/03/2018 |