Provider Demographics
NPI:1083971709
Name:STRAW, JOHN DAVID III (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:STRAW
Suffix:III
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WATER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17320-8252
Mailing Address - Country:US
Mailing Address - Phone:717-642-5902
Mailing Address - Fax:301-271-9223
Practice Address - Street 1:12 WATER ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:PA
Practice Address - Zip Code:17320-8252
Practice Address - Country:US
Practice Address - Phone:717-642-5902
Practice Address - Fax:301-271-9223
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03045237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist