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General NPI Number Information
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NPI Number | 1760949325
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Entity Type | Individual
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Provider Name | ALICIA WELLINGHOFF H.A.S.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2019
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 1111 MIAMISBURG CENTERVILLE RD
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City | WASHINGTON TOWNSHIP
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State | OH
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Zip | 45459-6713
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Country | US
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Telephone | 937-356-6741
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 WILDWOOD RD
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City | MIDDLETOWN
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State | OH
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Zip | 45042-2559
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Country | US
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Telephone | 937-260-8581
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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 | 03308
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License Number State | OH
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