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General NPI Number Information
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NPI Number | 1649123902
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Entity Type | Individual
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Provider Name | TIMOTHY JACOB DRYDEN
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Gender | Male
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 40 S PROGRESS DR STE C
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City | XENIA
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State | OH
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Zip | 45385-2685
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Country | US
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Telephone | 937-502-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 2063 LAKEWOOD DR
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City | DAYTON
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State | OH
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Zip | 45420-2003
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Country | US
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Telephone | 937-502-4257
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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 | IL.03587
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License Number State | OH
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