Provider Demographics
NPI:1720795396
Name:HUFFMAN, JESSE LEE (HEARING AID DEALER)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:HEARING AID DEALER
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:LEE
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HEARING AID DEALER
Mailing Address - Street 1:2205 E MORGAN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-4358
Mailing Address - Country:US
Mailing Address - Phone:812-475-1226
Mailing Address - Fax:
Practice Address - Street 1:2205 E MORGAN AVE STE 104
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4358
Practice Address - Country:US
Practice Address - Phone:812-475-1226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001579A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist