Healthcare Provider Details

I. General information

NPI: 1356536296
Provider Name (Legal Business Name): HBC MARTY LAYNE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 SPRING ST SUITE D
SCARBOROUGH ME
04074-7701
US

IV. Provider business mailing address

23 SPRING ST SUITE D
SCARBOROUGH ME
04074-7701
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-6466
  • Fax: 207-883-6556
Mailing address:
  • Phone: 207-883-6466
  • Fax: 207-883-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARTHA A LAYNE
Title or Position: GENERAL MANAGER
Credential: AU.D.
Phone: 207-883-6466