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NPI Code Detail

MEDICARE: FORREST NAYLOR HIS

MEDICARE: FORREST NAYLOR HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist8982CA

General Provider Information

NPI Number : 1174372486
Entity Type Code : Individual
Provider Name (Legal Business Name) : FORREST NAYLOR HIS
Provider Business Mailing Address
First Line : 103 CYPRESS ST
Second Line :
City : FORT BRAGG
State : CA
Zip : 95437-5401
Country : US
Telephone Number : 707-813-0999
Fax Number :
Provider Business Practice Location Address
First Line : 103 CYPRESS ST
Second Line :
City : FORT BRAGG
State : CA
Zip : 95437-5401
Country : US
Telephone Number : 707-813-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2024
Last Update Date : 05/17/2024

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