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General NPI Number Information
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NPI Number | 1245611656
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Entity Type | Organization
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Legal Business Name | CENTRAL MISSOURI AUDIOLOGY & HEARING AID CENTER, INC.
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 1145 S MORLEY ST
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City | MOBERLY
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State | MO
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Zip | 65270-1901
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Country | US
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Telephone | 660-998-3623
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 S MORLEY ST
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City | MOBERLY
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State | MO
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Zip | 65270-1901
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Country | US
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Telephone | 660-998-3623
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAIME HAMPSHIRE
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Credential | AUD
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Telephone | 660-998-3623
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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 | 2007027352
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License Number State | MO
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