Healthcare Provider Details
I. General information
NPI: 1770919987
Provider Name (Legal Business Name): LOVEWELL HEARING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2013
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44 PORTLAND ST
FRYEBURG ME
04037-1206
US
IV. Provider business mailing address
44 PORTLAND ST
FRYEBURG ME
04037-1206
US
V. Phone/Fax
- Phone: 207-935-1210
- Fax:
- Phone: 207-935-1210
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | DL383 |
| License Number State | ME |
VIII. Authorized Official
Name:
ALLISON
ANN
WOLFE
Title or Position: OWNER
Credential:
Phone: 207-935-1210