Individual
MRS. WANDA BATES CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFTS, CFM
Contact information
Practice address
139 E MAIN ST, FOREST CITY, NC 28043-3125
(828) 245-4591
(828) 245-1793
Mailing address
139 E MAIN ST, FOREST CITY, NC 28043-3125
(828) 245-4591
(828) 245-1793
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
CFM02654
NC
225000000X
Orthotic Fitter
Primary
CFTS0820
NC
Other
Enumeration date
01/19/2010
Last updated
07/30/2012
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