MEDICARE: JOHN W. DARR JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	AT000945L	PA

General Provider Information

NPI Number	:	1699965764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN W. DARR JR.

Provider Business Mailing Address
First Line	:	28 FRALEY ST
Second Line	:
City	:	KANE
State	:	PA
Zip	:	16735-1325
Country	:	US
Telephone Number	:	814-837-9366
Fax Number	:	814-837-9377

Provider Business Practice Location Address
First Line	:	28 FRALEY ST
Second Line	:
City	:	KANE
State	:	PA
Zip	:	16735-1325
Country	:	US
Telephone Number	:	814-837-9366
Fax Number	:	814-837-9377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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Directions to “ JOHN W. DARR JR. ” Practice Location

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