Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CFTS0480 | SC |
NPI | 1902072648 |
---|---|
Provider Name | Valerie L Oliver |
First Address | North Myrtle Beach, SC 29582-3023 |
Second Address | North Myrtle Beach, SC 29582-3023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2008 |
Last Update Date | 02/05/2008 |