Healthcare Provider Details

I. General information

NPI: 1265860381
Provider Name (Legal Business Name): THRIVE HEARING AND TINNITUS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 HIGHWAY 64 STE 500
EADS TN
38028-3370
US

IV. Provider business mailing address

3161 HIGHWAY 64 STE 500
EADS TN
38028-3370
US

V. Phone/Fax

Practice location:
  • Phone: 803-367-2355
  • Fax:
Mailing address:
  • Phone: 803-367-2355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1679
License Number StateTN

VIII. Authorized Official

Name: CASIE TYNES
Title or Position: PRACTICE OWNER
Credential: AUD
Phone: 803-367-2355