Healthcare Provider Details

I. General information

NPI: 1619051372
Provider Name (Legal Business Name): HEARING HEALTH CENTERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E 5TH ST
SPENCER IA
51301-5012
US

IV. Provider business mailing address

PO BOX 17
SPENCER IA
51301-0017
US

V. Phone/Fax

Practice location:
  • Phone: 712-262-7774
  • Fax:
Mailing address:
  • Phone: 712-262-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number075
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number706
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number177
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number949
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number928
License Number StateIA

VIII. Authorized Official

Name: DR. R DAVID NELSON
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 712-262-7774