Provider Demographics
NPI:1700143500
Name:DRS. D & W HENKER, P.C.
Entity Type:Organization
Organization Name:DRS. D & W HENKER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:208-265-4140
Mailing Address - Street 1:1333 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1734
Mailing Address - Country:US
Mailing Address - Phone:208-265-4140
Mailing Address - Fax:
Practice Address - Street 1:1333 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1734
Practice Address - Country:US
Practice Address - Phone:208-265-4140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP100005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty