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General NPI Number Information
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NPI Number | 1295002749
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Entity Type | Organization
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Legal Business Name | AUDIO EAR HEARING CENTER
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 65 S PLAZA WAY
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-5808
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Country | US
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Telephone | 573-334-7700
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Fax | 573-334-7700
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Provider Business Mailing Address
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Address Line | 65 S PLAZA WAY
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-5808
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Country | US
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Telephone | 573-334-7700
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Fax | 573-334-7700
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Authorized Official
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Title or Position | HEARING INSTRUMENT SPECIALIST
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Name | MR. DAREL E ROBERTS
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Credential |
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Telephone | 573-334-7700
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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 | 000748
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License Number State | MO
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