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General NPI Number Information
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NPI Number | 1386993475
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Entity Type | Organization
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Legal Business Name | DWIGHT D. ISENHOWARD
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 3314 HEALY DR STE 107
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City | WINSTON SALEM
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State | NC
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Zip | 27103
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Country | US
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Telephone | 336-774-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 4921 CARTNER RD
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City | JONESVILLE
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State | NC
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Zip | 28642
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Country | US
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Telephone | 336-774-0100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DWIGHT D ISENHOWARD
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Credential |
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Telephone | 336-774-0100
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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 |
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License Number State |
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