Healthcare Provider Details

I. General information

NPI: 1609116243
Provider Name (Legal Business Name): VENN VRANAS LICENSED HEARING AID
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 E MAIN ST STE 108
COTTAGE GROVE OR
97424-2204
US

IV. Provider business mailing address

1498 E MAIN ST STE 108
COTTAGE GROVE OR
97424-2204
US

V. Phone/Fax

Practice location:
  • Phone: 541-942-8444
  • Fax:
Mailing address:
  • Phone: 541-942-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number510970
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: