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General NPI Number Information
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NPI Number | 1437578143
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Entity Type | Organization
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Legal Business Name | DVC HEARING SERVICES INC
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 8771 PERIMETER PARK COURT SUITE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2278
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Country | US
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Telephone | 904-997-8585
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Fax | 904-998-0054
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Provider Business Mailing Address
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Address Line | 8771 PERIMETER PARK COURT SUITE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2278
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Country | US
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Telephone | 904-997-8585
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Fax | 904-998-0054
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Authorized Official
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Title or Position | OWNER
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Name | JOHN CHRISTIAN DERICKSON
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Credential | OD
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Telephone | 904-997-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AY1834
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License Number State | FL
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