Healthcare Provider Details

I. General information

NPI: 1457591414
Provider Name (Legal Business Name): HEATHER FOUST MARCHANT ABC CFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 OWEN DR
FAYETTEVILLE NC
28304-3414
US

IV. Provider business mailing address

234 OWEN DR
FAYETTEVILLE NC
28304-3414
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-9016
  • Fax: 910-486-8712
Mailing address:
  • Phone: 910-323-9016
  • Fax: 910-486-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: