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General NPI Number Information
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NPI Number | 1073034278
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Entity Type | Individual
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Provider Name | MICHELLE H HARTZOG
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 783 DOCTORS CT STE C
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City | ROXBORO
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State | NC
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Zip | 27573-4575
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Country | US
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Telephone | 336-597-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 5603 FALKIRK DR
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City | DURHAM
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State | NC
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Zip | 27712-1025
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Country | US
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Telephone | 919-482-9847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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