Healthcare Provider Details
I. General information
NPI: 1164651840
Provider Name (Legal Business Name): R & L HEARING CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2009
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
607 COUNTY ROAD 10 NE SUITE 101
BLAINE MN
55434-2373
US
IV. Provider business mailing address
203 N 8TH AVE E
DULUTH MN
55805-3254
US
V. Phone/Fax
- Phone: 763-783-7888
- Fax:
- Phone: 218-724-3477
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 2609 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 1284-060 |
| License Number State | WI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 2030 |
| License Number State | MN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 2689 |
| License Number State | MN |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 2664 |
| License Number State | MN |
VIII. Authorized Official
Name: MR.
DAVID
J
RUTFORD
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 218-724-3477