Healthcare Provider Details

I. General information

NPI: 1306226345
Provider Name (Legal Business Name): ELIZABETH HARDING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 FISHINGER RD SUITE E
COLUMBUS OH
43221-2114
US

IV. Provider business mailing address

1570 FISHINGER RD SUITE E
COLUMBUS OH
43221-2114
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-5848
  • Fax: 614-457-6316
Mailing address:
  • Phone: 614-457-5848
  • Fax: 614-457-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02632
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: