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General NPI Number Information
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NPI Number | 1104878503
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Entity Type | Organization
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Legal Business Name | MUSKEGON HEARING & SPEECH CENTER, INC.
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1155 E. SHERMAN BLVD
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City | MUSKEGON
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State | MI
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Zip | 49444-1450
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Country | US
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Telephone | 231-737-0527
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Fax | 231-733-4093
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Provider Business Mailing Address
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Address Line | 1155 E. SHERMAN BLVD
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City | MUSKEGON
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State | MI
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Zip | 49444-1450
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Country | US
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Telephone | 231-737-0527
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Fax | 231-733-4093
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROGER SMITH
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Credential | MA-CCC-A
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Telephone | 231-737-0527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | SB013583
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | KS001083
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | SB002162
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | KS761379
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License Number State | MI
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