Basic Information
| Provider Information | |||||||||
| NPI: | 1033545462 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COMBS | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | PARKER | ||||||||
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| Credential: | H.I.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1802 GALLOWAY ST | ||||||||
| Address2: | |||||||||
| City: | EAU CLAIRE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 547033467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158318966 | ||||||||
| FaxNumber: | 7158318968 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 N MITCHELL ST STE B | ||||||||
| Address2: | |||||||||
| City: | CADILLAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496011488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317790585 | ||||||||
| FaxNumber: | 2317798560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 09/17/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 3501006965 | MI | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.