Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1912189267 |
---|---|
Provider Name | Verlie Duvall |
First Address | Rancho Mirage, CA 92270-2873 |
Second Address | Rancho Mirage, CA 92270-2873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2007 |
Last Update Date | 28/11/2007 |