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General NPI Number Information
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NPI Number | 1174170393
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Entity Type | Organization
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Legal Business Name | JEAS HUNTER LLC
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 568 N OAK DR
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City | PLYMOUTH
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State | IN
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Zip | 46563-1664
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Country | US
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Telephone | 574-540-2526
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Fax |
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Provider Business Mailing Address
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Address Line | 568 N OAK DR
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City | PLYMOUTH
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State | IN
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Zip | 46563-1664
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Country | US
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Telephone | 574-540-2526
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Fax |
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Authorized Official
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Title or Position | OWNER/HIS
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Name | ALVIN NEIL HUNTER
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Credential | HIS
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Telephone | 574-540-2526
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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 |
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License Number State |
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