Individual
TERESA CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFOM
Contact information
Practice address
345 DEERFIELD RD, BOONE, NC 28607-5009
(828) 264-3055
Mailing address
345 DEERFIELD RD, BOONE, NC 28607-5009
(828) 264-3055
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
—
225000000X
Orthotic Fitter
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795358
—
NC
Enumeration date
05/22/2008
Last updated
02/08/2012
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