Healthcare Provider Details

I. General information

NPI: 1104954643
Provider Name (Legal Business Name): HEARING HEALTH CARE OF LA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4273 NORTH BLVD
BATON ROUGE LA
70806-3914
US

IV. Provider business mailing address

4273 NORTH BLVD
BATON ROUGE LA
70806-3914
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-3208
  • Fax: 225-387-3266
Mailing address:
  • Phone: 225-387-3208
  • Fax: 225-387-3266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number917
License Number StateLA

VIII. Authorized Official

Name: MR. RYAN T TEMPLET
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 225-387-3208