Organization
REGINALD J WIDICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD WIDICK (OWNER)
(270) 745-7182
Entity
Organization
Contact information
Practice address
1043 PEDIGO WAY, SUITE 40, BOWLING GREEN, KY 42103-7196
(270) 745-7182
Mailing address
330 FRANKLIN RD, SUITE 135A-121, BRENTWOOD, TN 37027-3280
(270) 745-7182
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Enumeration date
10/29/2012
Last updated
07/20/2015
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