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General NPI Number Information
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NPI Number | 1285295774
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Entity Type | Organization
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Legal Business Name | MOUNTAIN EARS HEARING CLINIC, LLC
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 3901 BRISCOE RUN RD STE 10
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City | PARKERSBURG
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State | WV
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Zip | 26104-8100
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Country | US
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Telephone | 314-324-0097
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Fax |
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Provider Business Mailing Address
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Address Line | 430 DAVIS RD
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City | LOWER SALEM
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State | OH
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Zip | 45745-8812
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Country | US
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Telephone |
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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 | ERIN DAVIS WELLS
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Credential | AU.D.
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Telephone | 314-324-0097
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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 |
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License Number State |
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