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General NPI Number Information
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NPI Number | 1962155713
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Entity Type | Individual
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Provider Name | HEATHER THORN HIS
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 5300 EDGEWOOD RD NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52411-4707
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Country | US
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Telephone | 319-363-0867
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Fax | 563-726-7383
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Provider Business Mailing Address
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Address Line | 404 E JEFFERSON ST
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City | CORYDON
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State | IA
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Zip | 50060-1530
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Country | US
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Telephone | 641-895-6160
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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 |
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License Number State |
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