Healthcare Provider Details

I. General information

NPI: 1770543415
Provider Name (Legal Business Name): STEVE LAVOIE HEARING AID DISPENSE
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 HIGH ST
AUBURN CA
95603-5016
US

IV. Provider business mailing address

1275 HIGH ST
AUBURN CA
95603-5016
US

V. Phone/Fax

Practice location:
  • Phone: 530-885-8350
  • Fax: 530-885-7237
Mailing address:
  • Phone: 530-885-8350
  • Fax: 530-885-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA2247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: