Healthcare Provider Details
I. General information
NPI: 1750894754
Provider Name (Legal Business Name): MY HEARING CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 E 4TH ST
THE DALLES OR
97058-2208
US
IV. Provider business mailing address
302 E 4TH ST
THE DALLES OR
97058-2208
US
V. Phone/Fax
- Phone: 541-397-0188
- Fax: 541-296-3300
- Phone: 541-397-0188
- Fax: 541-296-3300
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 10181198 |
| License Number State | OR |
VIII. Authorized Official
Name:
DUSTIN
JACOB
MCMINN
Title or Position: DIRECTOR OF HEARING SERVICES
Credential: HAS
Phone: 909-262-7027