Individual
EMILY IVY PAINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 881-4721
Mailing address
3342 GREEN ST, JACKSONVILLE, FL 32205-5712
(904) 881-4721
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPO03466
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS AND PROSTHETICS
—
Enumeration date
06/24/2022
Last updated
06/24/2022
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