Provider Demographics
NPI:1396834503
Name:DITTMER, JEFFREY CURTIS (AUD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CURTIS
Last Name:DITTMER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 LYONS RD
Mailing Address - Street 2:
Mailing Address - City:CLAYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15323-1288
Mailing Address - Country:US
Mailing Address - Phone:724-747-7581
Mailing Address - Fax:
Practice Address - Street 1:241 LYONS RD
Practice Address - Street 2:
Practice Address - City:CLAYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15323-1288
Practice Address - Country:US
Practice Address - Phone:724-747-7581
Practice Address - Fax:724-663-5360
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-000961L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist