NPI 1417292400

Derry Vansicklen, HAS

Practitioner Hearing Instrument Specialist Lady Lake, FL

Practice location

Address: 755 N US Highway 441, Lady Lake, FL 32159-3196
Phone: (352) 751-5860

Registered specialties

Hearing Instrument Specialist Primary

Speech, Language and Hearing Service Providers Taxonomy 237700000X Licence AS 4085 (FL)

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Registry record

NPI: 1417292400
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Dec 2012
Record last updated: 14 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.