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General NPI Number Information
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NPI Number | 1124060561
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY & HEARING CENTER OF FARMINGTON, INC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 620 WALTON DR
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City | FARMINGTON
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State | MO
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Zip | 63640-1935
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Country | US
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Telephone | 573-756-0500
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Fax | 573-756-0505
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Provider Business Mailing Address
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Address Line | 620 WALTON DR
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City | FARMINGTON
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State | MO
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Zip | 63640-1935
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Country | US
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Telephone | 573-756-0500
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Fax | 573-756-0505
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN RENEE MELTON
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Credential | AU.D.
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Telephone | 573-756-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 113484
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License Number State | MO
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