Provider Demographics
NPI:1114071693
Name:HILL, RICHARD CLYDE II
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CLYDE
Last Name:HILL
Suffix:II
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 1:230 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IRON RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49935-2219
Mailing Address - Country:US
Mailing Address - Phone:906-265-0711
Mailing Address - Fax:
Practice Address - Street 1:230 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-2219
Practice Address - Country:US
Practice Address - Phone:906-265-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002617237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist