Healthcare Provider Details
I. General information
NPI: 1437637543
Provider Name (Legal Business Name): METAMPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2018
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2803 JIM REDMAN PKWY STE 3
PLANT CITY FL
33566-9413
US
IV. Provider business mailing address
8300 CENTRAL PARK DR STE 100
WACO TX
76712-6666
US
V. Phone/Fax
- Phone: 813-754-3955
- Fax:
- Phone: 254-227-5189
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
L
KEY
Title or Position: COO
Credential:
Phone: 254-230-4149