Healthcare Provider Details

I. General information

NPI: 1093801557
Provider Name (Legal Business Name): HEARING EVALUATION AND REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 BATES ST.
LEWISTON ME
04240
US

IV. Provider business mailing address

12 BATES ST.
LEWISTON ME
04240
US

V. Phone/Fax

Practice location:
  • Phone: 207-782-1160
  • Fax: 207-783-4284
Mailing address:
  • Phone: 207-782-1160
  • Fax: 207-783-4284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberBU10000022
License Number StateME

VIII. Authorized Official

Name: BRYCE K. CROPPER
Title or Position: DIRECTOR OF AUDIOLOGY
Credential: MS, CCC-A
Phone: 207-782-1160