Individual
JIM WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
310 W BROOME ST, LAGRANGE, GA 30240-3185
(706) 882-5597
(706) 882-1362
Mailing address
137 LEE ROAD 2002, PHENIX CITY, AL 36870-8605
(706) 882-5597
(706) 882-1363
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
723
GA
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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