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General NPI Number Information
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NPI Number | 1346857042
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Entity Type | Individual
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Provider Name | COURTNEY LAUREN WEIGAND HIS
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Gender | Female
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Dates
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Enumeration Date | 09/26/2020
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Last Update Date | 09/26/2020
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Provider Practice Location Address
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Address Line | 269 WINTER ST
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City | HYANNIS
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State | MA
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Zip | 02601-2962
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Country | US
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Telephone | 774-487-8161
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Fax |
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Provider Business Mailing Address
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Address Line | 3928B W SCOTT ST
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City | JB MDL
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State | NJ
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Zip | 08641-1683
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Country | US
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Telephone | 774-487-8161
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 479
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License Number State | MA
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