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General NPI Number Information
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NPI Number | 1174913446
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Entity Type | Individual
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Provider Name | JOSHUA CREASY
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Gender | Male
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 809 US HIGHWAY 72 W SUITE G
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City | ATHENS
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State | AL
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Zip | 35611-4236
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Country | US
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Telephone | 256-233-3844
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Fax | 256-444-1784
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Provider Business Mailing Address
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Address Line | 809 US HIGHWAY 72 W SUITE G
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City | ATHENS
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State | AL
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Zip | 35611-4236
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Country | US
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Telephone | 256-233-3844
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Fax | 256-444-1784
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 4184
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License Number State | AL
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