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General NPI Number Information
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NPI Number | 1326547589
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Entity Type | Organization
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Legal Business Name | JMDLAD INC.
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 600 CARLISLE ST STE A
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City | HANOVER
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State | PA
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Zip | 17331-5100
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Country | US
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Telephone | 717-632-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CARLISLE ST STE A
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City | HANOVER
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State | PA
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Zip | 17331-5100
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Country | US
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Telephone | 717-632-5558
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RYAN OBERHOLTZER
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Credential |
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Telephone | 717-632-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | DO1044
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | DO1044
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License Number State | PA
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