MEDICARE: LINDSAY WENDLING 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
1	237700000X	Hearing Instrument Specialist	2020027611	MO

General Provider Information

NPI Number	:	1669251047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY WENDLING HIS

Provider Business Mailing Address
First Line	:	758 COBBLEFIELD CT
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3484
Country	:	US
Telephone Number	:	314-441-6084
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 W HIGHWAY D STE 204
Second Line	:
City	:	NEW MELLE
State	:	MO
Zip	:	63365-1019
Country	:	US
Telephone Number	:	314-441-6084
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	10/13/2023

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