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General NPI Number Information
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NPI Number | 1245572718
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Entity Type | Organization
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Legal Business Name | MID-VALLEY HEARING CENTER LLC
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Dates
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Enumeration Date | 03/22/2013
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Last Update Date | 03/22/2013
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Provider Practice Location Address
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Address Line | 3855 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9622
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Country | US
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Telephone | 304-760-8804
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9622
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Country | US
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Telephone | 304-760-8804
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | LISA A PAPA
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Credential | M.S.CCC-A
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Telephone | 304-760-8804
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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 | A-0099
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License Number State | WV
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