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General NPI Number Information
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NPI Number | 1164251815
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Entity Type | Organization
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Legal Business Name | TINNITUS & MISOPHONIA TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 07/31/2024
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 1301 RIVERPLACE BLVD STE 800
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9032
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Country | US
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Telephone | 844-432-7349
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Fax |
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Provider Business Mailing Address
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Address Line | 330 MOUNTS CORNER DR # 153
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City | FREEHOLD
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State | NJ
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Zip | 07728-2558
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Country | US
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Telephone | 844-432-7349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER ELFERT
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Credential | AU.D.
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Telephone | 917-579-3105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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