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General NPI Number Information
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NPI Number | 1194159772
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Entity Type | Organization
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Legal Business Name | CLEARLY HEARING INC
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Dates
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Enumeration Date | 08/30/2013
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 11665 S FORTUNA RD STE A
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City | YUMA
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State | AZ
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Zip | 85367-7736
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Country | US
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Telephone | 928-342-6000
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Fax | 928-569-0291
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Provider Business Mailing Address
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Address Line | 11665 S FORTUNA RD STE A
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City | YUMA
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State | AZ
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Zip | 85367-7736
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Country | US
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Telephone | 928-342-6000
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Fax | 928-569-0291
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WALTER KELLY JR.
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Credential | HIS
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Telephone | 928-342-6000
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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 | AZHAD8177
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License Number State | AZ
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