Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1639430457 |
---|---|
Provider Name | William A Bentley |
First Address | Fallon, NV 89406-4330 |
Second Address | Carson City, NV 89706-7794 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 17/12/2021 |