Provider Demographics
NPI:1245546449
Name:BLATTLER, DIETER H (HIS)
Entity type:Individual
Prefix:MR
First Name:DIETER
Middle Name:H
Last Name:BLATTLER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 CHONG ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1704
Mailing Address - Country:US
Mailing Address - Phone:808-961-9668
Mailing Address - Fax:
Practice Address - Street 1:166 CHONG ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1704
Practice Address - Country:US
Practice Address - Phone:808-961-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI124237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist