Healthcare Provider Details

I. General information

NPI: 1205297538
Provider Name (Legal Business Name): MICHAEL PRATT H.A.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2042 S BYRNE RD
TOLEDO OH
43614-5101
US

IV. Provider business mailing address

2042 S BYRNE RD
TOLEDO OH
43614-5101
US

V. Phone/Fax

Practice location:
  • Phone: 419-382-7427
  • Fax: 419-382-7714
Mailing address:
  • Phone: 419-382-7427
  • Fax: 419-382-7714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3021
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: