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General NPI Number Information
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NPI Number | 1255850418
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Entity Type | Organization
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Legal Business Name | LEGACY HEARING INCORPORATED
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2640 E 32ND ST STE 11
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City | JOPLIN
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State | MO
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Zip | 64804-4311
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Country | US
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Telephone | 417-553-0724
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Fax | 417-553-3478
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Provider Business Mailing Address
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Address Line | 2640 E 32ND ST STE 11
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City | JOPLIN
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State | MO
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Zip | 64804-4311
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Country | US
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Telephone | 417-553-0724
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Fax | 417-553-3478
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BILL BRODY RINK
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Credential | AAS-HIS
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Telephone | 417-553-0724
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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 | 001105
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 2015039402
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License Number State | MO
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