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Individual

DIMPLE MARTIN MCKINZEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.C.A.

Contact information

Practice address
302 E LOOP 281, LONGVIEW, TX 75605-7912
(903) 381-4044
(903) 381-4045
Mailing address
26222 RR 12, DRIPPING SPRINGS, TX 78620-4903
(512) 858-0300
(512) 858-2714

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
TX50491
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528945-01
TX
Enumeration date
11/03/2006
Last updated
08/20/2010
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