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General NPI Number Information
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NPI Number | 1114144490
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Entity Type | Organization
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Legal Business Name | MEADVILLE HEARING CLINIC II, INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 04/04/2017
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Provider Practice Location Address
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Address Line | 1142 S ROGERS ST
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City | CLARKSVILLE
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State | AR
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Zip | 72830-9157
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Country | US
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Telephone | 479-754-7710
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Fax | 479-754-8910
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Provider Business Mailing Address
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Address Line | 1142 S ROGERS ST
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City | CLARKSVILLE
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State | AR
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Zip | 72830-9157
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Country | US
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Telephone | 479-754-7710
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Fax | 479-754-8910
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. VICKI LYNN HOWARD
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Credential | B.S., B.C.H.I.S.
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Telephone | 479-754-7710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 420
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License Number State | AR
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