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Individual

KATHERINE R STANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFM

Contact information

Practice address
2830 MAPLEWOOD AVE STE A, WINSTON SALEM, NC 27103-4114
(336) 331-3480
(336) 793-1218
Mailing address
2830 MAPLEWOOD AVE STE A, WINSTON SALEM, NC 27103-4114
(336) 331-3480
(336) 793-1218

Taxonomy

Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
225000000X
Orthotic Fitter
Primary
23483
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7701864
NC
Enumeration date
04/24/2006
Last updated
10/06/2022
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