Healthcare Provider Details

I. General information

NPI: 1174241699
Provider Name (Legal Business Name): HOPE HEARING & TINNITUS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 BOYSON RD
HIAWATHA IA
52233-2313
US

IV. Provider business mailing address

1727 BOYSON RD
HIAWATHA IA
52233-2313
US

V. Phone/Fax

Practice location:
  • Phone: 319-393-2796
  • Fax: 319-393-4782
Mailing address:
  • Phone: 319-393-2796
  • Fax: 319-393-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA L KELLOGG
Title or Position: AUDIOLOGIST / OWNER
Credential: AU.D.
Phone: 319-393-2796