Individual
BLAINE N WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LO CO LPA
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
180
TX
222Z00000X
Orthotist
Primary
28
OK
225000000X
Orthotic Fitter
1148
TX
225000000X
Orthotic Fitter
9
OK
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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