Healthcare Provider Details

I. General information

NPI: 1518369198
Provider Name (Legal Business Name): HEARING CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 W GAINES ST
LAWRENCEBURG TN
38464-3604
US

IV. Provider business mailing address

307 W GAINES ST
LAWRENCEBURG TN
38464-3604
US

V. Phone/Fax

Practice location:
  • Phone: 931-766-0799
  • Fax: 931-766-5955
Mailing address:
  • Phone: 931-766-0799
  • Fax: 931-766-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA1160
License Number StateTN

VIII. Authorized Official

Name: MRS. DIANE KARNES BRINK
Title or Position: AUDIOLOGIST
Credential: MS, CCC-A
Phone: 931-766-0799