Individual
MRS. NANCY JEANNE TOLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BOC CERTIFIED
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2275
REGISTERED
—
01
—
C17591
BOARD OF CERTIFICATION NU
—
Enumeration date
11/22/2006
Last updated
07/08/2007
Update your record
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