Individual
KEISHA HUNTERRORIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1058 W CLUB BLVD, 623, DURHAM, NC 27701-1104
(919) 423-5376
Mailing address
1058 W CLUB BLVD, 623, DURHAM, NC 27701-1104
(919) 423-5376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
174400000X
NC
1744P3200X
Prosthetics Case Management
Primary
—
NC
Other
Enumeration date
09/25/2016
Last updated
10/10/2016
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