Healthcare Provider Details

I. General information

NPI: 1689193484
Provider Name (Legal Business Name): CLEAR CHOICE HEARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 09/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 AIRPORT RD STE 29
CONCORD NH
03301-5326
US

IV. Provider business mailing address

52 MOUNTAIN RD
BROOKLINE NH
03033-2491
US

V. Phone/Fax

Practice location:
  • Phone: 800-717-5004
  • Fax:
Mailing address:
  • Phone: 603-321-4826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberH518
License Number StateNH

VIII. Authorized Official

Name: JOHN CANCELLIERI
Title or Position: OWNER
Credential: BC-HIS
Phone: 603-321-4826