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General NPI Number Information
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NPI Number | 1205067113
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Entity Type | Organization
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Legal Business Name | THE AUDIOLOGY CENTER OF LORAIN CO. INC
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 07/28/2009
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Provider Practice Location Address
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Address Line | 6100 S BROADWAY SUITE 102
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City | LORAIN
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State | OH
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Zip | 44053-3875
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Country | US
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Telephone | 440-246-4327
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Fax | 440-246-4327
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Provider Business Mailing Address
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Address Line | 6100 S BROADWAY SUITE-102 THE AUDIOLOGY CENTER
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City | LORAIN
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State | OH
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Zip | 44053-3875
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Country | US
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Telephone | 440-246-4327
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Fax | 440-246-4327
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Authorized Official
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Title or Position | PRESIDENT-OWNER-AUDIOLOGIST
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Name | MRS. LILLIAN REYNOLDS MITHCHELL
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Credential | MA-CCCA FAAA
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Telephone | 440-246-4327
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A0171
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License Number State | OH
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