Healthcare Provider Details

I. General information

NPI: 1053609263
Provider Name (Legal Business Name): MOBILE MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 COMMERCE DR STE A
PERRYSBURG OH
43551-5276
US

IV. Provider business mailing address

12910 SHELBYVILLE RD STE 300
LOUISVILLE KY
40243-2404
US

V. Phone/Fax

Practice location:
  • Phone: 502-244-2420
  • Fax: 502-996-8282
Mailing address:
  • Phone: 502-813-4415
  • Fax: 502-996-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number01331
License Number StateOH

VIII. Authorized Official

Name: MR. ANDREW FELTZ
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 502-813-4415