Healthcare Provider Details

I. General information

NPI: 1093267668
Provider Name (Legal Business Name): IOWA HEARING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 LAVENDER PKWY STE 130
FARIBAULT MN
55021-5087
US

IV. Provider business mailing address

131 ENTERPRISE RD
JOHNSTOWN NY
12095-3326
US

V. Phone/Fax

Practice location:
  • Phone: 507-333-5056
  • Fax:
Mailing address:
  • Phone: 401-353-4174
  • Fax: 401-488-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: CORY POPELKA
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential:
Phone: 507-333-5056