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Individual

MR. LAVERNE CLARENCE WILLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICENSED HEARING INS

Contact information

Practice address
2525 WEST MAIN, SUITE 106, RAPID CITY, SD 57702-2438
(605) 355-9776
Mailing address
2525 W MAIN, SUITE 106 HEAR BETTER HERE HEARING CENTER, RAPID CITY, SD 57702-2438
(605) 355-9776

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
257
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9159920
SD
Enumeration date
06/17/2008
Last updated
06/17/2008
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