Healthcare Provider Details

I. General information

NPI: 1346648516
Provider Name (Legal Business Name): HEARTLAND HEARING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2014
Last Update Date: 04/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3726 QUEEN CT SW SUITE 105
CEDAR RAPIDS IA
52404-3903
US

IV. Provider business mailing address

3726 QUEEN CT SW SUITE 105
CEDAR RAPIDS IA
52404-3903
US

V. Phone/Fax

Practice location:
  • Phone: 319-409-5786
  • Fax:
Mailing address:
  • Phone: 319-409-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DIANA KAIN
Title or Position: AUDIOLOGIST
Credential:
Phone: 319-321-3982