Individual
MRS. MARY L BAYSDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFOM CFTS
Contact information
Practice address
480 E 9TH ST, LUMBERTON, NC 28358-4880
(910) 272-9900
(910) 671-1983
Mailing address
PO BOX 3576, LUMBERTON, NC 28359-3576
(910) 272-9900
(910) 671-1983
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
CFOM0662
NC
335E00000X
Prosthetic/Orthotic Supplier
Primary
CFTS0275
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033392717
—
NC
Enumeration date
12/17/2007
Last updated
05/02/2011
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