Healthcare Provider Details

I. General information

NPI: 1770683799
Provider Name (Legal Business Name): HEARING UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N BALTIMORE ST SUITE B
KIRKSVILLE MO
63501-3200
US

IV. Provider business mailing address

400 N BALTIMORE ST SUITE B
KIRKSVILLE MO
63501-3200
US

V. Phone/Fax

Practice location:
  • Phone: 660-665-9114
  • Fax: 660-665-9114
Mailing address:
  • Phone: 660-665-9114
  • Fax: 660-665-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1080
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0725
License Number StateMO

VIII. Authorized Official

Name: MR. GARY E FRY
Title or Position: CO-OWNER/SPECIALIST
Credential: H.I.S.
Phone: 660-665-9114