Individual
BRIAN THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HIS
Contact information
Practice address
7110 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3216
(863) 324-2288
Mailing address
7110 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3216
(863) 324-2288
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS5734
FL
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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