Provider Demographics
NPI:1083250724
Name:RICE, DWIGHT LEE
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:LEE
Last Name:RICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 MEMORIAL PKWY NW STE 14
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5935
Mailing Address - Country:US
Mailing Address - Phone:256-533-1605
Mailing Address - Fax:
Practice Address - Street 1:1407 MEMORIAL PKWY NW STE 14
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5935
Practice Address - Country:US
Practice Address - Phone:256-533-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty