Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFTS1167 | DE |
NPI | 1003110362 |
---|---|
Provider Name | Tina Shook Hammonds |
First Address | Laurinburg, NC 28352-4721 |
Second Address | Laurinburg, NC 28352-4721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2010 |
Last Update Date | 22/01/2014 |