Provider Demographics
NPI:1235500786
Name:HULLER, GARY
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:HULLER
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 1:2140 W ARLINGTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5709
Mailing Address - Country:US
Mailing Address - Phone:252-355-0909
Mailing Address - Fax:
Practice Address - Street 1:2140 W ARLINGTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5709
Practice Address - Country:US
Practice Address - Phone:252-355-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1182237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist