Individual
MR. WOLODYMYR R. STASIUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACA, BC-HIS
Contact information
Practice address
124 GLANCY ST, GOODLETTSVILLE, TN 37072-2306
(615) 851-3901
(615) 851-3903
Mailing address
124 GLANCY ST, GOODLETTSVILLE, TN 37072-2306
(615) 851-3901
(615) 851-3903
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
410
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42-1566005
FEDERAL TAX I.D. NUMBER
TN
Enumeration date
01/04/2007
Last updated
07/08/2007
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