Healthcare Provider Details

I. General information

NPI: 1871503573
Provider Name (Legal Business Name): HOOSIER HEARING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 W BLOOMFIELD ROAD SUITE 3
BLOOMINGTON IN
47403-2052
US

IV. Provider business mailing address

1355 W BLOOMFIELD ROAD SUITE 3
BLOOMINGTON IN
47403-2052
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-5633
  • Fax: 812-332-5671
Mailing address:
  • Phone: 812-332-5633
  • Fax: 812-332-5671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002164A
License Number StateIN

VIII. Authorized Official

Name: JENNIFER LYNN ROGERS
Title or Position: OWNER/AUDIOLOGIST
Credential:
Phone: 812-332-5633