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Individual

WADE RIX SAMFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11020 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(855) 823-9355
Mailing address
PO BOX 356, MINNEAPOLIS, MN 55440-0356

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA60804937
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HA60804937
HEARING INSTRUMENT SPECIALIST
WA
Enumeration date
11/07/2019
Last updated
11/07/2019
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