Healthcare Provider Details

I. General information

NPI: 1700161049
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 1ST ST E
INDEPENDENCE IA
50644-3155
US

IV. Provider business mailing address

6700 WASHINGTON AVE S STE 300-N
EDEN PRAIRIE MN
55344-3405
US

V. Phone/Fax

Practice location:
  • Phone: 319-234-4630
  • Fax: 319-235-5360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BEE XIONG
Title or Position: MANAGER OF REVENUE CYCLE
Credential:
Phone: 952-995-6601