Doctor Name: | MARY ELLEN HADDOCK |
NPI Number: | 1487950077 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFTS |
License Number: | CFTS1166 |
Business Practice Address: | 131 Third Street Ayden, NC - 285137252 |
Business Phone Number: | 2527463492 |
Business Fax Number: | 2527464838 |
Mailing Address: | 131 Third Street, AYDEN |
State: | NC |
Postal Code: | 285137252 |
Phone Number: | 2527463492 |
Fax Number: | 2527464838 |
NPI Enumeration Date: | 01/31/2011 |
NPI Last Update Date: | 01/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225000000X |
License Number: | CFTS1166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Orthotic Fitter |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |