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General NPI Number Information
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NPI Number | 1205283728
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Entity Type | Organization
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Legal Business Name | MIRACLE-EAR
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 1012 W PIERCE ST STE A
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City | CARLSBAD
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State | NM
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Zip | 88220-4034
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Country | US
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Telephone | 575-887-2318
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Fax | 575-887-0189
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Provider Business Mailing Address
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Address Line | 1012 W PIERCE ST STE A
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City | CARLSBAD
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State | NM
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Zip | 88220-4034
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Country | US
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Telephone | 575-887-2318
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Fax | 575-887-0189
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Authorized Official
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Title or Position | HEARING INSTRUMENT SPECIALIST
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Name | MS. LYNDSAY KING
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Credential | H.I.S.
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Telephone | 545-887-2318
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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 | 0867
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License Number State | NM
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