Organization · Type 2 NPI
Mary Diane Johnson TMD Outlet
Orthotic Fitter · Lebanon, MO
NPI number
1649389388
Active
Practice location
702 S Monroe
Lebanon, MO 65536-3570
Fax (417) 588-3404
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthotic Fitter Primary | 225000000X | None listed |
Orthotic Fitter: An individual trained in the management of fitting prefabricated orthoses.
About NPI 1649389388
Mary Diane Johnson TMD Outlet's National Provider Identifier is 1649389388, issued on Aug 29, 2006. The primary taxonomy on file is Orthotic Fitter (225000000X), and the practice location is in Lebanon, MO. The record was last updated on Jun 16, 2008.