Healthcare Provider Details

I. General information

NPI: 1245786706
Provider Name (Legal Business Name): MCGUIRE HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SOUTHMOOR CIR NE
DAYTON OH
45429-2451
US

IV. Provider business mailing address

15 SOUTHMOOR CIR NE
DAYTON OH
45429-2451
US

V. Phone/Fax

Practice location:
  • Phone: 937-293-7877
  • Fax:
Mailing address:
  • Phone: 937-293-7877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.01897
License Number StateOH

VIII. Authorized Official

Name: DR. STEPHANIE ELIZABETH MCGUIRE
Title or Position: OWNER
Credential: AU.D.
Phone: 937-293-7877