Healthcare Provider Details

I. General information

NPI: 1972942332
Provider Name (Legal Business Name): THE TINNITUS TREATMENT CENTER, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WEBB PL
DOVER NH
03820-2462
US

IV. Provider business mailing address

3 WEBB PL
DOVER NH
03820-2462
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-1780
  • Fax: 603-749-3934
Mailing address:
  • Phone: 603-749-1780
  • Fax: 603-749-3934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA354
License Number StateNH

VIII. Authorized Official

Name: CAROL ANN J MANNING-COUTURE
Title or Position: OWNER
Credential: AU.D.
Phone: 603-749-1780