Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1841482544 |
---|---|
Provider Name | Wanda Jean Cox |
First Address | Fairmont, NC 28340-1904 |
Second Address | Fairmont, NC 28340-1904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 16/08/2007 |