Provider Demographics
NPI:1437553526
Name:RHIDDLEHOOVER, JAMES C
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:RHIDDLEHOOVER
Suffix:
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 1:1201 N. PINAL AVE.
Mailing Address - Street 2:SUITE A
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122
Mailing Address - Country:US
Mailing Address - Phone:520-494-2242
Mailing Address - Fax:866-675-2158
Practice Address - Street 1:1201 N. PINAL AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:520-494-2242
Practice Address - Fax:866-675-2158
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD5429237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist