Healthcare Provider Details

I. General information

NPI: 1972666519
Provider Name (Legal Business Name): NUTONE HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 W PIKE ST
CLARKSBURG WV
26301-2649
US

IV. Provider business mailing address

756 W PIKE ST
CLARKSBURG WV
26301-2649
US

V. Phone/Fax

Practice location:
  • Phone: 304-624-0530
  • Fax: 304-624-7091
Mailing address:
  • Phone: 304-624-0530
  • Fax: 304-624-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number924
License Number StateWV

VIII. Authorized Official

Name: MR. BRADLEY J SPROUSE
Title or Position: OWNER
Credential: H.I.S.
Phone: 304-624-0530