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General NPI Number Information
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NPI Number | 1215436316
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Entity Type | Organization
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Legal Business Name | HOMETOWN HEARING & AUDIOLOGY, LLC
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 225 E MAIN ST
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1824
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Country | US
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Telephone | 260-306-3444
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Fax | 260-306-3777
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Provider Business Mailing Address
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Address Line | 225 E MAIN ST
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1824
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Country | US
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Telephone | 260-306-3444
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Fax | 260-306-3777
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. BRANDY K WEAVER
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Credential | AU.D.
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Telephone | 260-306-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002531A
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License Number State | IN
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