Provider Demographics
NPI:1932506011
Name:GUYLL, JAMES WILLARD JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLARD
Last Name:GUYLL
Suffix:JR
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 1:210 E 30TH AVE
Mailing Address - Street 2:STE 112
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-2475
Mailing Address - Country:US
Mailing Address - Phone:620-665-7551
Mailing Address - Fax:620-662-5281
Practice Address - Street 1:210 E 30TH AVE
Practice Address - Street 2:STE 112
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-2475
Practice Address - Country:US
Practice Address - Phone:620-665-7551
Practice Address - Fax:620-662-5281
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS966237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist