| Organization Name: | REGINALD J WIDICK |
| NPI Number: | 1023362118 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REGINALD WIDICK (OWNER) |
| Mailing Address: | 1043 Pedigo Way Suite 40 Bowling Green |
| State: | KY US |
| Postal Code: | 421037196 |
| Phone Number: | 2707457182 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 07/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |