Individual
JULIANN KAY DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.-H.I.S.
Contact information
Practice address
5200 WASHINGTON AVE STE 102, RACINE, WI 53406-4238
(262) 637-5668
(262) 637-5009
Mailing address
5200 WASHINGTON AVE STE 102, RACINE, WI 53406-4238
(262) 637-5668
(262) 637-5009
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
402
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42812800
—
WI
Enumeration date
03/14/2008
Last updated
03/14/2008
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