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General NPI Number Information
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NPI Number | 1225159577
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEARING CTR PC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 415 E 23RD ST SUITE A
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City | FREMONT
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State | NE
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Zip | 68025-2393
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Country | US
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Telephone | 402-721-8960
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Fax | 402-721-7988
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Provider Business Mailing Address
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Address Line | 415 E 23RD ST SUITE A
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City | FREMONT
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State | NE
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Zip | 68025-2393
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Country | US
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Telephone | 402-721-8960
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Fax | 402-721-7988
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Authorized Official
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Title or Position | OWNER AUDIOLOGIST
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Name | EVELYN V MCKNIGHT
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Credential | AUD
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Telephone | 402-721-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 49
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License Number State | NE
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